右美托咪定在鼻内窥镜手术患者的应用  

Application of dexmedetomidine in patients undergoing nasal endoscopic surgery

作　　者：单希胜[1] 钱菊[1] 

机构地区：[1]苏州大学附属第一医院麻醉科,江苏省215006

出　　处：《江苏医药》2017年第20期1464-1467,共4页Jiangsu Medical Journal

摘　　要：目的观察右美托咪定(DEX)在鼻内窥镜手术患者的应用效果。方法 74例择期行鼻内窥镜手术患者采用静-吸复合麻醉,术中实施控制性降压。随机均分为两组:DEX组麻醉诱导前10min内静脉泵入DEX 1.0μg/kg;对照组泵入等量生理盐水。记录两组麻醉诱导前(T0)、气管插管后(T1)、控制性降压开始后5min(T2)、降压30min(T3)、拔管后5min(T4)和拔管后30min(T5)时的MAP和HR。评估Fromme术野质量(SSFQ)评分、Ramsay镇静评分和VAS疼痛评分。计算术中麻醉药物用量。观察麻醉恢复及不良反应发生情况。结果 DEX组在T0~T5时HR均低于对照组(P<0.05),但MAP差异无统计学意义(P>0.05)。DEX组SSFQ评分在T2、T3时均低于对照组(P<0.05),而Ramsay镇静评分在T4时高于对照组(P<0.05)。DEX组术中芬太尼的用量少于对照组(P<0.05)。DEX组苏醒时间长于对照组(P<0.05),术后谵妄和躁动的发生率低于对照组(P<0.05)。结论鼻内窥镜手术患者麻醉前应用DEX能减少其他麻醉药物用量,改善麻醉恢复过程。Objective To observe the efficacy of dexrnedetomidine in the patients undergoing nasal endoscopic surgery. Methods Seventy-four patients underwent nasal endoscopic surgery under combined intravenous and sevoflurane inhalation anesthesia. The deliberate hypotension was performed during operation. The patients were divided into two groups with 37 cases each. Dexmedetomidine 1.0 μg/kg was infused in 10 minutes before anesthesia induction in group A. The equal volume of saline instead of dexmedetomidine was infused in group B. MAP and HR were recorded before anesthesia（T0）, soon after intubation （T1）, at 5 minutes （T2） and 30 minutes （T3） after deliberate hypotension, at 5 minutes（T4） and 30 minutes （T5） after extubatiorL The Fromme field quality （SSFQ） score, Ramsay sedation score and VAS pain score were evaluated. The consumption of fentanil during operation was calculated. The incidence of adverse effects was observed. Results The HR at T0-T5 was lower in group A than that in group B（P〈0. 05）,but MAP was not significantly different between two groups（P〈0. 05）. The SSFQ score of group A was lower than that of group B at T2 and T3（P〈0. 05）,while Ramsay sedation score was higher in group A than that of group B at T4（P〈0.05）. The consumption of fentanil during operation at T3 was less in group A than that in group B（P〈0. 05）. The awakening time was longer and the incidences of delirium and restlessness were lower in group A than those in group B（P〈0. 05）. Conclusion Application of dexmedetomidine before anesthesia induction may reduce the consumption of other anesthetics and improve the recovery process of anesthesia in the patients undergoing nasal endoscopic surgery.

关 键 词：右美托咪定 鼻内窥镜手术 控制性降压 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]