右美托咪定对经鼻中隔-蝶窦垂体瘤切除术患者苏醒期的影响  

Effects of dexmedetomidine on the emergence of patients undergoing transnasal transsphenoidal pituitary tumor resection

作　　者：唐帅[1] 薛杨[1] 张良燕[1] 梁蒙 邓侃[3] 张砡[1] 易杰[1] 张秀华[1] 黄宇光[1] 

机构地区：[1]中国医学科学院北京协和医院麻醉科,100730 [2]威海市中心医院麻醉科 [3]中国医学科学院北京协和医院神经外科,100730

出　　处：《临床麻醉学杂志》2017年第5期446-448,共3页Journal of Clinical Anesthesiology

摘　　要：目的评估右美托咪定行对经鼻中隔-蝶窦垂体瘤切除术患者苏醒期的影响。方法选择拟在全麻下行择期垂体瘤切除术患者124例,年龄18~65岁,ASAⅠ或Ⅱ级。采用随机数字表法将患者分为右美托咪定组(D组,n=62)和对照组(C组,n=62)。两组患者均以丙泊酚、芬太尼、罗库溴铵、地塞米松和昂丹司琼静脉诱导,七氟醚、氧气和氧化亚氮吸入维持,D组术中静脉泵注右美托咪定,C组泵注等量生理盐水,记录两组患者的拔管时间和PACU停留时间;记录苏醒期躁动、呛咳以及术后24h内咽痛及声音嘶哑的发生情况。结果共119例最终纳入分析,其中D组57例,C组62例。D组拔管时间[(29.7±11.5)min vs(22.2±8.5)min]和PACU停留时间[(41.5±11.8)min vs(35.3±10.0)min]明显长于C组(P<0.05)。两组苏醒期躁动(26.3%vs 32.3%)、呛咳(49.1%vs 53.2%)及术后24h内咽痛(14.0%vs 24.2%)和声音嘶哑(10.5%vs 19.4%)发生率差异无统计学意义。结论术中使用右美托咪定可提高经鼻中隔-蝶窦垂体瘤切除术患者术后对气管导管的耐受,不影响术后躁动、呛咳、咽痛、声音嘶哑的发生率。Objective To evaluate the effect of dexmedetomidine on the tolerance to endotra- cheal tube, on agitation and other complications of patients undergoing transnasal transsphenoidal pi- tuitary tumor resection. Methods One hundred and twenty-four patients aged 18-65 years, ASA physical status I or U ） were randomly assigned to dexmedetomidine group （group D, n=60） and control group （group C, n = 62）. Group D were given intravenous infusion of dexmedetomidine during the operation and group C with saline. The extubation time, observation time in the post-anesthesia care unit （PACU）, the incidence of emergence agitation, cough, postoperative sore throat and hoarseness were analyzed. Results The extubation time [ （29.7 ± 11.5） rain vs （22.2 ± 8.5） min] and the length of stay in PACU [（41.5±11.8） min vs （35.3±10. 0） mini were significantly longer in group D than those in group C （P〈0.05）. There was no significant difference of the incidence of e- mergence agitation （26.3% vs 32.3%）, cough （49.1% vs 53.2%）, postoperative sore throat （14.0% vs 24. 2%） and hoarseness （10.5% vs 19.4G） between two groups. Conclusion Intraoper- ative intravenous administration of dexmedetomidine can prolong the extubation time and the length of stay in PACU. The incidence of agitation, cough, postoperative sore throat and hoarseness was not affected by dexmedetomidine.

关 键 词：垂体瘤切除术 苏醒期躁动 右美托咪定 

分 类 号：R614[医药卫生—麻醉学] R736.4[医药卫生—外科学]