小剂量右美托咪定联合利多卡因对全麻高血压患者深麻醉下拔管后恢复质量的影响  

Effects of Low Dose Dexmedetomidine Combined with Lidocaine on the Recovery Quality of Hypertension Patients Whom Extubated under Deep Anesthesia

作　　者：左琴蓉 张义华 罗辉宇 杜振杰 徐姝珺 ZUO Qin-rong;ZHANG Yi-hua;LUO Hui-yu(Postgraduate Training Basement of Jinzhou Medical University,Xiangyang NO.1 Peoples Hospital,Xiangyang(441000),China)

机构地区：[1]锦州医科大学襄阳市第一人民医院研究生培养基地,襄阳441000 [2]湖北医药学院附属襄阳市第一人民医院麻醉科,襄阳441000

出　　处：《中国中西医结合外科杂志》2020年第6期1057-1061,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:观察小剂量的右美托咪定联合利多卡因对全麻高血压患者深麻醉下拔管后恢复质量的影响。方法:择期行腹腔镜手术的全麻高血压患者40例,采用随机数字表法,分成两组,每组均20例。右美托咪定联合利多卡因组(DL组)使用小剂量右美托咪定0.3μg/(kg·h)联合利多卡因1.5 mg/(kg·h),丙泊酚组(P组)使用丙泊酚4 mg/(kg·h)。观察并记录入室后(T1)、气管拔管后即刻(T2)、气管拔管后10 min(T3)、气管拔管后30 min(T4)各时间点的MAP、HR;PaCO2、PaO2;血糖;拔管时间、苏醒时间;拔管后并发症;术后30 minVAS评分。结果:在T4时相DL组的MAP低于P组[(90.6±11.9)mmHg vs(97.2±7.3)mmHg],差异有统计学意义(P<0.05);在T2、T3、T4时相,DL组的HR低于P组,差异有统计学意义(P<0.05);在T3时相DL组的PaCO2低于P组[(45.6±2.3)mmHg vs(48.4±2.5)mmHg],DL组的PaO2高于P组[(89.5±4.9)mmHg vs(84.2±3.2)mmHg],差异有统计学意义(P<0.05);在T4时相DL组的血糖低于P组[(7.2±1.4)mmol/L vs(8.7±0.8)mmol/L],差异有统计学意义(P<0.05);两组患者的拔管时间差异无统计学意义(P>0.05);DL组的苏醒时间比P组短[(2.9±1.8)min vs(4.1±1.7)min],差异有统计学意义(P<0.05);DL组患者舌后坠发生率(0%)比P组(25%)低,差异有统计学意义(P<0.05);DL组术后30 min VAS评分(2.3±1.0)小于P组(4.2±0.8),差异有统计学意义(P<0.05)。结论:小剂量右美托咪定联合利多卡因用于全麻高血压患者深麻醉下拔管,可以显著提高患者全麻苏醒期的恢复质量,具有良好的临床应用价值。Objective To observe the effects of low-dose dexmedetomidine combined with lidocaine on the recovery quality of hypertension patients whom extubated under deep anesthesia.Methods Forty hypertension patients who underwent the elective laparoscopic general anesthesia surgery were selected.The patients were divided into two groups with random number table method,and each group included 20 cases.The dexmedetomidine combined with lidocaine group(DL group)used low-dose dexmedetomidine 0.3μg/(kg·h)combined with lidocaine 1.5 mg/(kg•h),and the propofol group(P group)used propofol 4 mg/(kg·h).At each time point which after entering the room(T1),immediately after tracheal extubation(T2),10 minutes after tracheal extubation(T3),and 30 minutes after tracheal extubation(T4),the MAP,HR,PaCO2,PaO2,blood glucose,the extubation time and recovery time,post-extubation complications,postoperative 30-minute VAS scores were observed and recorded.Results At time pionts of T4,the MAP of DL group was lower than that of P group(90.6±11.9 mmHg vs 97.2±7.3 mmHg),which the difference was statistically significant(P<0.05).At time pionts of T2,T3 and T4,the HR of DL group was lower than that of P group,which the difference was statistically significant(P<0.05).At time pionts of T3,the PaCO2 of DL group was lower than that of P group(45.6±2.3 mmHg vs 48.4±2.5 mmHg),and the PaO2 of DL group was higher than that of P group(89.5±4.9 mmHg vs 84.2±3.2 mmHg),which the difference was statistically significant(P<0.05).At time pionts of T4,blood glucose in DL group was lower than that in group P(7.2±1.4 mmol/L vs 8.7±0.8 mmol/L),which the difference was statistically significant(P<0.05).There was no significant difference in the extubation time between the two groups of patients(P>0.05).The recovery time of DL group was shorter than that of P group(2.9±1.8 min vs 4.1±1.7 min),which the difference is statistically significant(P<0.05).The incidence of tongue fall(0%)in DL group was lower than that in group P(25%),which the difference was st

关 键 词：右美托咪定 利多卡因 丙泊酚 高血压 深麻醉下拔管 

分 类 号：R614.2[医药卫生—麻醉学]