右美托咪定对七氟醚麻醉患者苏醒呼末七氟醚浓度的影响  

The effect of dexmedetomidine on the end-tidal concentration of sevoflurane during recovery from breast cancer surgery under general anaesthesia

作　　者：汪芳俊[1] 胡建华[1] 李洪琼[1] 王艺铮[1] 曾悦怡[1] WANG Fangjun;HU Jianhua;LI Hongqiong;WANG Yizheng;ZENG Yueyi(Department of Anesthesiology, the Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China)

机构地区：[1]川北医学院附属医院麻醉科,637000

出　　处：《天津医药》2016年第8期1036-1039,共4页Tianjin Medical Journal

基　　金：四川省医学会课题(EH-MN14-06)

摘　　要：目的观察术中输注不同剂量右美托咪定对七氟醚麻醉患者苏醒时呼末七氟醚浓度及躁动的影响。方法择期行单侧乳腺癌根治术患者120例，年龄35～56岁，随机分为4组，每组30例。D0.5、D0.6、D0.7组分别给予右美托咪定0.5、0.6、0.7μg/（kg·h），C组给予生理盐水；观察并记录患者术中、术后各时段呼末七氟醚浓度，记录患者苏醒时呼末七氟醚浓度，观察患者苏醒情况和停药至苏醒拔管时间，观察患者麻醉苏醒拔管情况，并根据Riker’s镇静-躁动评分进行评估。记录手术时间、麻醉时间、术中瑞芬太尼用量、术中听觉诱发电位指数（AAI）、七氟醚吸入浓度及相应时间。结果4组患者一般资料、瑞芬太尼用量、手术时间和术中AAI值差异均无统计学意义，D0.7组麻醉时间较其他3组延长（P<0.05）。与C组比较，D0.5、D0.6和D0.7组术中不同时段七氟醚吸入浓度均降低，苏醒时间延长，苏醒时呼末七氟醚浓度降低，且D0.7组苏醒时间较D0.5、D0.6组延长，苏醒时呼末七氟醚浓度低于D0.5组，与D0.6组差异无统计学意义。与C组比较，D0.5、D0.6和D0.7组Riker’s镇静-躁动评分达到7分的比例降低（P<0.05）；D0.6和D0.7组评分达到4分的比例较C组和D0.5组高，而达到6分的比例较C组和D0.5组低（P<0.05）；D0.7组患者评分达到3分的比例高于其他3组（P<0.05）。术中D0.6组和D0.7组分别有4例（13%）和8例（27%）发生心动过缓。结论七氟醚吸入麻醉中静脉输注右美托咪定0.6μg（/kg·h）可有效减少术中七氟醚的用量并降低苏醒时呼末七氟醚浓度，减少患者吸入全麻苏醒躁动的发生。Objective To investigate the effects of dexmedetomidine on the end-tidal concentration of sevoflurane during recovery from breast cancer surgery under general anaesthesia. Methods A total of 120 patients undergoing unilateral breast cancer radical operation were randomly divided into four groups: group C (infusion of saline, n=30), group D0.5 [infusion of dexmedetomidine 0.5 μg/(kg·h) during operation, n=30],group D0.6 [dexmedetomidine 0.6 μg/(kg·h), n=30] and group D0.7 [dexmedetomidine 0.7 μg/(kg·h), n=30]. The end-tidal concentrations of sevoflurane during surgery and postoperation were observed. The end- tidal concentration of sevoflurane on palinesthesia was recorded. The time from stopping administration of anesthetic drug to palinesthesia and the operation time were recorded. The palinesthesia of patients from general anaesthesia and the degree of emergence agitation of the patient were measured using Riker’s sedation-agitation scale. The operation time, anesthesia time, intraoperative remifentanil dosage, intraoperative auditory evoked potential index (AAI), sevoflurane inhalation concentration and the corresponding time were recorded. Results There were no significant differences in clinical data, remifentanil dosage, operation time and AAI between four groups. The anesthesia time was longer in group D0.7 than that in the other three groups (P < 0.05). Compared to group C, the end-tidal concentration of sevoflurane during surgery, postoperation and palinesthesia were lower and the time of palinesthesia was delayed in groups D0.5,D0.6 and D0.7 (P < 0.05). And the time of palinesthesia was delayed in group D0.7 than that of group D0.5 and group D0.6. Compared with group C, the ratio of Riker’s sedation-agitation scale >7 was lower in groups D0.5,D0.6 and D0.7 (P < 0.05). The ratio of Riker’s sedation-agitation scale >4 was significantly higher in group D0.6 and group D0.7 than that in group C and group D0.5, but the ratio of score>6 was lower(P < 0.05). The ratio of score>3 was higher in group

关 键 词：麻醉药 吸入 右美托咪定 七氟醚 吸入麻醉 浓度 苏醒 

分 类 号：R614.2[医药卫生—麻醉学]