右美托咪定围术期全时程应用于胃癌根治术患者的临床研究  

Clinical Study of Full-time Administration of Dexmedetomidine for Perioperation in Patients Undergoing Radical Gastrectomy

作　　者：杨柳青[1] 陈鑫[1] 魏端高 罗小会[1] 吴红[1] 沈邮静[1] Yang Liuqing;Chen Xin;Wei Duangao;Luo Xiaohui;Wu Hong;Shen Youjing(Department of Anesthesiology,North Jiangsu People′s Hospital,Yangzhou 225001,China)

机构地区：[1]苏北人民医院麻醉科

出　　处：《湖北民族学院学报（医学版）》2019年第4期36-38,共3页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的探讨全时程右美托咪定(DEX)用于胃癌根治术患者围术期舒适化麻醉的可行性。方法选择择期行胃癌根治术患者64例,随机数字表法分为常规麻醉组(C组)和DEX全时程应用组(D组),C组静脉给予咪唑安定0.05 mg/kg,舒芬太尼0.3μg/kg,顺阿曲库胺0.2 mg/kg,丙泊酚1 mg/kg后行气管插管,D组入手术间前20 min用DEX 2μg/kg滴鼻,术中按0.5μg/(kg h)DEX静脉输注,术后患者自控静脉镇痛泵使用舒芬太尼2.5μg/kg+阿扎司琼10 mg+DEX 0.1μg/(kg h)。记录抵达手术室后BIS、有创操作的舒适度评价(NRS)、苏醒期躁动评分、术后镇痛评分(VAS);记录气管插管及拔管时MAP、HR以及术后不良反应的发生情况;术后48 h行满意度评价(NAS)。结果D组BIS值、插管、拔管时MAP和HR均明显低于C组(P<0.05),术后D组NRS评分、苏醒期躁动评分和VAS评分均明显低于C组(P<0.05),NAS评分D组明显高于C组(P<0.05);D组恶心呕吐和术后谵妄发生率明显低于C组(P<0.05)。结论DEX可围术期全时程应用于胃癌根治术患者,提高患者舒适度及满意度。Objective To evaluate the feasibility of full-time administration of Dexmedetomidine for perioperative comfort anesthesia of patients undergoing radical gastrectomy.Methods 64 patients undergoing elective radical gastrectomy were randomly divided into the control group(group C)and the dexmedetomidine full-time application group(group D).The group C was given intravenous midazolam 0.05 mg/kg,sufentanil 0.3μg/kg,cis-atracurium 0.2 mg/kg and propofol 1 mg/kg,then tracheal intubation.The Group D was given drops nasal with dexmedetomidine 2μg/kg 20 min before going to the operation room.In addition,The group D was given intraoperative infusion of 0.5μg/(kg h)dexmedetomidine and was given postoperative patient-controlled intravenous analgesia pump of sufentanil 2.5μg/kg,azastron 10 mg and dexmedetomidine 0.1μg/(kg h).The records of BIS,operation comfort degree score,arousal agitation score,postoperative analgesia score,MAP and HR and postoperative adverse reactions during tracheal intubation and extubation were recorded.Lastly,postoperatively satisfaction was evaluated.Results The BIS,MAP and HR in the D group were significantly lower than those in the group C(P<0.05).The Numerical Rating Scale(NRS),the arousal agitation score and the visual analog scale(VAS)of the D group were significantly lower than those of the group C(P<0.05),the NAS score in group D was significantly higher than that in group C(P<0.05)and the incidence of nausea and vomiting and postoperative delirium in the group D was significantly lower than that in group C(P<0.05).Conclusion Full-time administration of dexmedetomidine for perioperation can improve the comfort and satisfaction of patients with radical gastrectomy.

关 键 词：DEX 胃癌根治术 舒适化麻醉 

分 类 号：R614[医药卫生—麻醉学]