右美托咪定联合复方利多卡因乳膏预防胸科手术后全麻苏醒期躁动和尿管刺激反应  

Dexmedetomidine combined with compound lidocaine cream in prevention of anesthesia emergence agitation and urinary catheter-induced discomfort after thoracic surgery

作　　者：何世琼[1] 纪宏新[2] 杨丽娜[1] 陈文[2] 邓玉春 李安学[2] 

机构地区：[1]深圳市龙岗区人民医院胸外科,广东深圳518172 [2]深圳市龙岗区人民医院麻醉科,广东深圳518172

出　　处：《中国新药与临床杂志》2017年第11期653-657,共5页Chinese Journal of New Drugs and Clinical Remedies

基　　金：深圳市科创委科研项目(J20160422141605247)

摘　　要：目的观察右美托咪定联合复方利多卡因乳膏预防男性患者胸科手术后苏醒期躁动和尿管刺激反应的临床效果。方法择期行开胸手术的男性患者100例,随机分右美托咪定组(D组)、利多卡因组(L组)、右美托咪定联合利多卡因组(DL组)和对照组(P组),每组25例。所有患者均在全麻后置入硅胶导尿管,D组和P组导尿管前端常规涂抹石蜡油,L组和DL组导尿管前端涂抹复方利多卡因乳膏。D组和DL组手术结束前30 min予右美托咪定1μg·kg^(-1)静脉泵注15 min,P组和L组相同方法给予氯化钠注射液。记录患者麻醉诱导前(T_0)、气管拔管即刻(T_1)和拔管后3 min(T_2)、10 min(T_3)、20 min(T_4)时的收缩压(SBP)、心率(HR)、血氧饱和度及拔管后患者躁动评分、疼痛VAS评分和尿道刺激症状程度。结果 T_1~T_4时D组和DL组SBP、HR低于L组和P组(P<0.05),T_2~T_3时L组SBP、HR低于P组(P<0.05)。D组、L组和DL组苏醒期躁动的发生率均低于P组(P<0.05),而D组和L组间比较无显著差异(P>0.05)。D组和DL组苏醒期VAS评分明显低于P组和L组(P<0.05),L组与P组间比较无显著差异(P>0.05)。尿管刺激反应发生率,D组、L组和DL组均低于P组(P<0.05)。结论右美托咪定联合复方利多卡因乳膏可有效地预防、减轻男性患者胸科手术后全麻苏醒期躁动和尿管刺激反应,且不影响患者血流动力学和术后苏醒。AIM To investigate the effect of dexmedetomidine combined with compound lidocaine cream in prevention of anesthesia emergence agitation and urinary catheter-induced discomfort of male patients after thoracic surgery. METHODS One hundred male patients undergoing selective thoracic surgery were enrolled and divided into four groups randomly, dexmedetomidine group（ group D）, lidocaine group（ group L）,dexmedetomidine combined with lidocaine group（ group DL） and control group（ group P）, each group of 25 cases. Urinary catheterization was performed using a silicone catheter after anesthesia induction. The group D and group P used paraffin oil daub routine catheterization catheter front end, while the group L and group DL used compound lidcoaine cream daub catheter front of urethral catheterization. The group D and group DL were given intravenous pumped infusion of dexmedetomidine 1 μg·kg-1 in 15 min before the end of surgery, while the group P and group L were given sodium chloride injection by the same methods. The systolic blood pressure（ SBP）,heart rate（ HR） and pulse oxygen saturation were recorded at the time points of before induction（ T0）,tracheal extubation immediately（ T1）, 3 min（T2）, 10 min（T3） and 20 min（T4） after tracheal extubation.The agitation scores, visual analogue scale（VAS） for pain and degree of urinary catheter-induced discomfort after tracheal extubation were also recorded. RESULTS The SBP and HR of the group D and group DL were lower than the group L and group P at T1 to T4（P 〈 0.05）. The SBP and HR of the group L were lower than the group P at T2 to T3（P 〈 0.05）. The incidence of emergence agitation in the group D, group L and group DL were significantly lower than in the group P（P 〈 0.05）, but no statistical differences existed between the group D and group L（P 〉 0.05）. The VAS scores in the group D and group DL were significantly lower than in the group P and group L（P 〈 0.05）, but no statistical differences existe

关 键 词：右美托咪定 利多卡因 胸外科手术 躁动 尿管刺激反应 

分 类 号：R971[医药卫生—药品]