右美托咪定辅助全身麻醉下肺部分切除术患者术后苏醒延迟及寒颤的影响研究  

Effect of Dexmedetomidine-assisted General Anesthesia on Postoperative Delayed Recovery and Shivering of Patients with Pneumoresection

作　　者：付武昌 冯艳 左友波[2] 高金蓉 李雪[3] Fu Wuchang;Feng Yan;Zuo Youbo;Gao Jinrong;Li Xue(Department of Anesthesiology,Nanchong Central Hospital,Nanchong 637000,China;Department of Anesthesiology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China;Department of Obstetrics and Gynecology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]南充市中心医院麻醉科,南充637000 [2]川北医学院附属医院麻醉科,南充637000 [3]川北医学院附属医院妇产科,南充637000

出　　处：《成都医学院学报》2018年第2期205-209,共5页Journal of Chengdu Medical College

摘　　要：目的观察右美托咪定辅助麻醉对肺部分切除术患者术后苏醒质量的影响。方法选取2014年10月至2016年9月于南充市中心医院和川北医学院附属医院就诊的肺癌患者168例,按照随机数字表法分为右美托咪定组(观察组)和生理盐水组(对照组),每组84例,观察两组患者麻醉前5min(T0)、切皮前3min(T1)、切皮时(T2)、停用全麻药时(T3)、停用麻药30 min(T4)、苏醒拔管时(T5)6个时间点患者的心率(HR)、平均动脉压(MAP)和血氧饱和度(SpO_2)及术后VAS、Ramsay镇静评分、苏醒质量和不良反应。结果两组患者在T0、T1和T2时间点HR、MAP和SpO_2指标方面比较,差异无统计学意义(P>0.05),在T3~T5时间点两组患者在HR、MAP指标方面比较,差异具有统计学意义(P<0.05),两组SpO_2无明显变化,差异无统计学意义(P>0.05);观察组、对照组Ramsay评分分别为(2.97±0.84)和(3.84±1.12)分(P<0.05);VAS评分分别为(2.67±1.19)和(3.72±1.52)分(P<0.05);术后寒颤率分别为5.95%和23.81%(P<0.05);寒战持续时间分别为(45.25±8.34)和(56.18±11.31)min(P<0.05);两组麻醉后苏醒时间比较,差异无统计学意义(P>0.05);观察组不良反应发生率低于对照组,差异具有统计学意义(P<0.05)。结论右美托咪定辅助全身麻醉对患者有镇静和镇痛作用,能降低患者血流动力学波动、术后疼痛及寒颤发生率,且对患者延迟苏醒影响较小,不良反应发生率低。Objective To investigate the effect of dexmedetomidine-assisted general anesthesia on the postoperative delayed recovery and shivering of patients with pneumoresection.Methods A total of 168 lung cancer patients treated with pneumoresection from October of 2014 to September of 2016 in Nanchong Central Hospital and Affiliated Hospital of North Sichuan Medical College were selected and divided into the dexmedetomidine group(observation group)and the normal saline group(control group)according to the random number table method,and each group included 84 cases.The data including the heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO 2),postoperative scores of VAS and Ramsay,recovery time,shivering occurrence and incidence of adverse reactions in the two groups were observed at 5 min before anesthesia(T0),3 min before skin incision(T1),the time of stopping using general anesthetics(T2),the time of skin incision(T3),30 min after stopping using anesthetics(T4)and at extubation time(T5)respectively.Results There were no significant differences between the two groups at time points of T0,T1 and T2 in the levels of HR,MAP and SPO 2(P>0.05),while there were significant differences between the two groups at time points of T3,T4 and T5 in the levels of HR and MAP(P<0.05).The two groups were not significantly different in SpO 2(P>0.05).The Ramsay scores were(2.97±0.84)in the observation group and(3.84±1.12)in the control group and the VAS scores were(2.67±1.19)in the observation group and(3.72±1.52)in the control group,the postoperative shivering incidences were 5.95%in the observation group and 23.81%in the control group,and the shivering duration were(45.25±8.34)min in the observation group and(56.18±11.31)min in the control group.All those differences between two groups were statistically significant(P<0.05).There was no significant difference in the recovery time between two groups(P>0.05),while the incidence of adverse reactions was significantly lower in the observation group than in the control group

关 键 词：右美托咪定 全身麻醉 苏醒延迟 寒颤 

分 类 号：R614.2[医药卫生—麻醉学]