右美托咪定在局麻扁桃体切除术中的作用观察  

Effect of dexmedetomidine on tonsillectomy under local anesthesia

作　　者：张明阳 胡环宇 杨夏[1] 陶宏[1] ZHANG Mingyang HU Huanyu YANG Xial TAO Hong(Department of Anesthesiology, Tengzhou Central People＇s Hospital, Tengzhou 277500, China Department of Otolaryngology, Tengzhou Central People＇s Hospital, Tengzhou 277500, China)

机构地区：[1]山东省滕州市中心人民医院麻醉科,滕州277500 [2]山东省滕州市中心人民医院耳鼻喉科,滕州277500

出　　处：《上海医药》2017年第19期35-37,共3页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:观察右美托咪定对扁桃体切除术局麻效果的影响。方法:局麻下行扁桃体切除术患者90例,随机分为单纯局麻组(A组)和右美托咪定组(B1和B2组),每组30例。右美托咪定组患者术前先经输液泵缓慢静脉注射右美托咪定0.5μg/kg负荷剂量,15 min泵完之后开始手术,然后B1组以0.5μg/(kg·h),B2组以1.0μg/(kg·h)速率持续泵注至术毕。单纯局麻组持续泵注相同容量的生理盐水至术毕。记录各组患者手术中的相关数据及不良反应。结果:B1和B2组的手术时间和出血量均低于A组(P<0.05);在T1,T2,T3时B1和B2组MAP和HR均低于A组(P<0.05);B1和B2组的焦虑和镇痛评分及恶心呕吐和寒战发生比例低于A组,镇静评分高于A组,B2组心动过缓的发生比例高于A组(P<0.05)。结论:术中泵注右美托咪定可以减少局麻扁桃体术中生命体征的波动,减少术中出血,缩短手术时间,增强镇痛镇静效果,减轻焦虑,降低不良反应发生率,但术中泵注右美托咪定1.0μg/(kg·h)增加心动过缓的发生率。Objective： To investigate the anesthetic effects of dexmedetomidine on tonsillectomy under local anesthesia. Methods： Ninety cases of tonsillectomy were randomly divided into group A （local anesthesia） and group B 1 and B2 （additionally giving dexmedetomidine） with thirty cases each. Patients in both group B1 and B2 were intravenously pumped 0.5 μg/kg of dexmedetomidine within 15 min before operation and then maintained at 0.5 μg/（kg-h） in group B1 and 1.0 gg/（kg.h） in group B2 till the end of surgery. The related data and adverse reactions in each group were recorded. Results： The amount of bleeding and operation time were less in group Bland B2 than group A （P〈0.05）. MAP and HR were lower in group B1 and B2 than group A at each monitoring time point （P〈0.05）.The scores of analgesia, anxiety and the incidence of nausea, vomiting and shivering were lower and the scores of sedation were higher in group B1 and B2 than group A （P〈0.05）, while the incidence of bradycardia was higher in group B2 than group A （P〈0.05）. Conclusion： Appropriate amount of dexmedetomidine pumped during operation can decrease fluctuations in vital signs, reduce the amount of bleeding and operation time, enhance analgesic and sedation effects, relieve anxiety and reduce the incidence of adverse reactions. However, dexmedetomidine intravenously pumped at 1.0 μg/（kg·h） can increase the incidence of bradycardia.

关 键 词：右美托咪定 扁桃体 切除术局麻 

分 类 号：R614[医药卫生—麻醉学]