盐酸右美托咪定对老年患者腹腔镜腹股沟疝修补术后残余肌松效应的影响  

Effects of Dexmedetomidine on Residual Neuromuscular Blockade in Elderly Patients After Laparoscopic Inguinal Hernia Repair

作　　者：杜彦茹[1] 韩霜[1] 张秀果[1] DU Yanru;HAN Shuang;ZHANG Xiuguo(Departmennt of Anesthesiology,Hebei Genneral Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院麻醉科,石家庄050051

出　　处：《医药导报》2018年第8期964-966,共3页Herald of Medicine

基　　金：河北省2011年医学科学研究重点科题(20110212)

摘　　要：目的观察术中持续输注盐酸右美托咪定对老年患者腹腔镜腹股沟疝修补术后残余肌松效应的影响。方法择期行腹腔镜腹股沟疝修补术老年患者60例,年龄65~85岁,体质量指数19~25 kg·(m^2)^(-1),ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将患者随机分为2组:对照组(C组)和盐酸右美托咪定组(M组),每组30例。M组麻醉诱导后输注盐酸右美托咪定1μg·kg^(-1)·h^(-1),随后以0.5μg·kg^(-1)·h^(-1)速率持续静脉泵注至手术结束前10 min,C组泵注等容量的0.9%氯化钠注射液。上肢前臂尺神经两侧连接加速度肌松监测仪,监测拇内收肌颤搐情况。记录临床时效(第一个肌颤搐恢复到25%时间)、恢复指数(t1从25%恢复至75%的时间)、拔除气管插管30 min后及术后3 h残余肌松效应发生率(TOFR<0.9表示发生残余肌松效应)。结果 C组和M组临床时效分别为(24.0±2.7)和(23.6±3.1)min;恢复指数分别为(63±6)和(60±5);拔管后30 min残余肌松效应发生分别为26和25例;术后3 h残余肌松效应发生分别为3和2例。与C组比较,M组恢复指数、拔管30 min后及术后3 h残余肌松发生率均差异无统计学意义(P>0.05)。结论术中持续输注盐酸右美托咪定对腹腔镜腹股沟疝修补术老年患者残余肌松效应发生率无影响。Objective To observe the influence of continuous infusion of dexmedetomidine in elderly patients on residual neuromuscular blockade after laparoscopic inguinal hernia repair. Methods Sixty ASA physical status Ⅰ or Ⅱpatients of both sexes,aged 65-85 years,body mass index 19-25 kg ·（ m^2）^-1,scheduled for laparoscopic inguinal hernia repair,were randomly divided into two groups（ n = 30 each） by using a random number table： control group（ group C） and dexmedetomidine group（ group M）. In group M,dexmedetomidine 1 μg · kg^-1· h^-1 and 0. 5 μg · kg^-1· h^-1 was infused intravenously after induction of anesthesia until 10 min before the end of operation,while the equal volume of 0. 9% sodium chloride solution was given into the group C. Clinical effect,the index of recovery,the rate of residual neuromuscular blockade 30 min after extubation and 1 h after operation（ TOFR0.9 represents residual neuromuscular blockade） were recorded. Results Clinical time limit was（ 24.0±2.7） and（ 23.6±3.1） min in group C and group M,respectively. Recovery index was（ 63±6） and（ 60±5）,respectively; postoperative residual curarization appeaved in 26 and 25 cases,respectively 30 min after extubation,and it appeared in 3 and 2 cases,respectively 3 h after the surgery in group C and group M.There were no significant differences in recovery index and the rate of residual neuromuscular blockade 30 min after extubation and 3 h after the operation（ P〉0.05）.Conclusion Continuous infusion of dexmedetomidine in elderly patients has no effects on residual neuromuscular blockade.

关 键 词：右美托咪定 盐酸 患者 老年 残余肌松 腹股沟疝修补术 

分 类 号：R971.2[医药卫生—药品] R256.45[医药卫生—药学]