右美托咪定复合舒芬太尼清醒镇静术在普外科日间手术中的应用  

Application of Dexmedetomidine Combined with Sufentanil Conscious Sedation in Daytime Surgery

作　　者：杨舜敏[1] 

机构地区：[1]上海市浦东新区人民医院麻醉科,上海201200

出　　处：《医学临床研究》2017年第8期1472-1474,共3页Journal of Clinical Research

摘　　要：【目的】探讨右美托咪定复合舒芬太尼清醒镇静术在普外科日间手术中的效果及可行性。【方法】将64例普外科日间手术患者随机分为两组，各32例。右美托咪定组（A组）术前泵注右美托咪定0.3ug／kg，10rain后静注舒芬太尼0．1μg／kg，术中泵注右美托咪定0．2～0．4μg／（kg·min）维持麻醉；丙泊酚组（B组）给予舒芬太尼0．1μg／kg＋丙泊酚1．5mg／kg，术中泵注丙泊酚3～61．5mg／（kg·h）维持麻醉。比较两组手术情况，记录术前（T0）、手术开始时（T1）、手术开始10min（T2）、60min（T3）、出室（T4）点时平均动脉压（MAP）、心率（HR）、血氧饱和度（SpOz）、改良警觉一镇定评分（OAA／s评分）变化。【结果】A组苏醒时间、恢复室停留时间均短于B组，且差异有显著性（P〈0．05）；A组T1～T3点时MAP、SP〈02、OAA／s评分高于B组（P〈0．05），两组不同时间点HR比较差异均无显著性（P〉0．05）；两组患者对术中情况的记忆比较差异无显著性（P〉0．05）；A组低血压、嗜睡、呼吸抑制发生率均低于B组（P〈0．05）。【结论】与丙泊酚相比，普外科日间手术给予右美托咪定复合舒芬太尼清醒镇静在缩短术后清醒时间、维持血流动力学稳定、减少不良反应方面更具优势，虽顺应性遗忘效应相对较低，但不会影响手术的正常进行。[Objective]To investigate the effect and feasibility of dexmedetomidine combined with sufentanil in sedation during the daytime surgery in the department of general surgery.[Methods] Six-four cases of patients un dergoing daytime surgery were randomly divided into two groups by random, 32 cases in each group. Dexmedeto midine group （group A） received dexmedetomidine 0.3 g/kg before operation, and sufentanil 0.1g/kg 10rain after intravenous injection. Dexmedetomidine was pumped between 0.2 and 0.4 g/kg rain in operation to maintain anesthesia; Propofol group （group B） received sufentanil 0.1 g/kg ＋ propofol 1.5mg/kg, intraoperative pumpe propo- fol 3-61.5 mg/（kg·h） for anesthesia maintenance. The operation of the two groups was compared, and the changes of mean arterial pressure point （MAP） , heart rate （HR）, oxygen saturation （SpO2）, OAA/S score at time points such as pre-operation （T0）, the beginning of the operation （T1）, 10min surgery （T2）, 60rain surgery （T3） and a chamber （T4） were recorded.[Results]The recovery time and length of stay in recovery room of the group A were shorter than those of the group B, and the difference was significant （ P 〈0.05）. T1-T3, MAP, SpO2 and OAA/S score of the group A were higher than those of the group B （ P〈0.05）. There was no significant difference in HR between the two groups at different time points （ P〉0.05）. There was no significant differ ence in operation memory between the two groups （ P 〉0.05） ; The incidence rates of hypotension, lethargy and respiratory depression in the dexmedetomidine group were lower than those in the propofol group （ P 〈 0.05）. [Conclusion]Compared with propofol, the combination of dexmedemmidine and sufentanil for sedation during daytime surgery in the department of general surgery has more advantages in shortening postoperative wake time, maintaining hemodynamic stability and reducing adverse reactions. Although the effect of adaptive forgetting effect is relatively

关 键 词：右关托咪啶/治疗应用 舒芬太尼/治疗应用 清醒镇静 外科手术 

分 类 号：R61[医药卫生—外科学]