羟考酮联合右美托咪定对全麻苏醒期躁动及应激反应的影响  

Effect of oxycodone combined with dexmedetomidine on general anesthesia emergence agitation and stress response

作　　者：杨庆耿 孙岸灵[2] 郭文斌 朱思佳 张伟娟 

机构地区：[1]惠州市第一妇幼保健院麻醉科 [2]惠州市中心人民医院麻醉科,广东惠州516000

出　　处：《海南医学院学报》2017年第10期1348-1351,共4页Journal of Hainan Medical University

基　　金：惠州市科技计划项目(20160802)~~

摘　　要：目的:探讨羟考酮联合右美托咪定对腹部手术患者全麻苏醒期躁动及应激反应的影响。方法:收集在本院进行全麻下腹部手术的患者118例,随机分为对照组(n=59)、观察组(n=59)。对照组患者接受常规麻醉+羟考酮干预,观察组患者接受常规麻醉+羟考酮联合右美托咪定干预。对比两组PACU中苏醒期躁动发生率;手术结束即刻(T1)、拔管后3min(T2)、拔管后10min(T3),检测血清中应激相关指标的含量。结果:观察组在PACU期间的躁动发生率显著低于对照组患者(P<0.05)。T1时,两组血清中RAS指标、胰岛素抵抗指标、甲状腺激素的差异无统计学意义(P>0.05);T2、T3时,两组患者血清中RAS指标REN、AngⅡ、ALD,胰岛素抵抗指标FBG、FINS、HOMA-IR,甲状腺激素FT3、FT4、TSH均显著高于T1时间点,且观察组患者REN、AngⅡ、ALD、FBG、FINS、HOMA-IR、FT3、FT4、TSH的水平显著低于对照组患者(P<0.05)。结论:羟考酮联合右美托咪定可减少腹部手术患者全麻苏醒期躁动发生率,减轻全身应激反应。Objective： To study the effect of oxycodone combined with dexmedetomidine on general anesthesia emergence agitation and stress response in patients with abdominal operation.Methods： A total of 118 patients who received abdominal operation under general anesthesia in our hospital between May 2014 and May 2016 were collected and randomly divided into control group （n=59） and observation group （n=59）.Control group of patients received general anesthesia ＋ oxycodone intervention, and the observation group of patients received routine anesthesia ＋ oxycodone combined with dexmedetomidine intervention.The incidence of emergence agitation in the PACU was compared between two groups of patients;immediately after operation （T1）, 3 min after extubation （T2） and 10 min after extubation （T3）, serum levels of stress-related indexes were detected.Results： The incidence of emergence agitation in the PACU of observation group was significantly lower than that of control group （P〈0.05）.At T1, differences in serum RAS indexes, insulin resistance indexes and thyroid hormones were not statistically significant between two groups of patients （P〉0.05）;at T2 and T3, serum RAS indexes REN, AngⅡ and ALD, insulin resistance indexes FBG, FINS and HOMA-IR as well as thyroid hormones FT3, FT4 and TSH of both groups of patients were significantly higher than those at T1, and REN, AngⅡ, ALD, FBG, FINS, HOMA-IR, FT3, FT4 and TSH levels of observation group were significantly lower than those of control group （P〈0.05）.Conclusions： Oxycodone combined with dexmedetomidine can reduce the incidence of general anesthesia emergence agitation and reduce the systemic stress reaction in patients with abdominal operation.

关 键 词：腹部手术 右美托咪定 羟考酮 苏醒期躁动 应激反应 

分 类 号：R656[医药卫生—外科学]