不同剂量右美托咪定联合地佐辛在鼻内镜下鼻窦手术中的麻醉效果  

Anesthetic Effects of Different Doses of Dexmedetomidine Combined with Dezocine in Endoscopic Sinus Surgery

作　　者：林仲智 艾东亮 黄文科 陈灵珠 夏博文 王友澄 Lin Zhongzhi;Ai Dongliang;Huang Wenke;Chen Lingzhu;Xia Bowen;Wang Youcheng(Jiexi County Hospital of Traditional Chinese Medicine,Jieyang Guangdong 515431,China)

机构地区：[1]揭西县中医医院,广东揭阳515431

出　　处：《医疗装备》2021年第9期82-85,共4页Medical Equipment

基　　金：2020年揭阳市卫生医疗类项目(YLWS076)。

摘　　要：目的比较不同剂量右美托咪定联合地佐辛在鼻内镜下鼻窦手术中的麻醉效果。方法选择2017年9月至2020年9月于医院择期行鼻内镜下鼻窦手术的患者120例,按照随机数字表法分为A、B、C、D 4组,每组30例。4组均采用气管插管全身麻醉;在此基础上,A、B、C组在麻醉诱导前10 min静脉泵注右美托咪定[A组采用低剂量(0.5μg/kg),B组采用中剂量(0.75μg/kg),C组采用高剂量(1.0μg/kg)],并在10 min内泵注完毕,随后以0.5μg/(kg·h)速度持续泵注右美托咪定至手术结束;手术结束前,A、B、C组静脉注射5 mg地佐辛,D组则静脉注射等剂量0.9%氯化钠注射液;比较4组气管插管前、气管插管即刻、气管插管后10 min的平均动脉压和心率水平,拔管时间、苏醒时间、苏醒期躁动发生率和术后镇痛满意度,以及术后麻醉相关并发症发生率。结果气管插管前、气管插管即刻、气管插管后10 min,A、B、C组的平均动脉压和心率水平均低于D组(P<0.05),但3组间比较无明显差异(P>0.05);4组拔管时间、苏醒时间比较,差异无统计学意义(P>0.05);A、B、C组苏醒期躁动发生率低于D组,术后镇痛满意度高于D组,差异均有统计学意义(P<0.05);4组术后均未发生麻醉相关并发症。结论在鼻内镜下鼻窦手术中采用右美托咪定联合地佐辛麻醉,能维持患者术中血流动力学稳定,降低苏醒期躁动发生率,提高镇痛满意度,且不会延长复苏时间。Objective The anesthetic effects of different doses of dexmedetomidine combined with dezocine in endoscopic sinus surgery were compared.Methods A total of 120 patients scheduled for endoscopic sinus surgery in the hospital from September 2017 to September 2020 were selected and divided into 4 groups(A,B,C and D)according to random number table,with 30 cases in each group.General anesthesia with tracheal intubation was used in the four groups.On this basis,dexmedetomidine was intravenously pumped 10 minutes before anesthesia induction in groups A,B and C[group A received low dose(0.5μg/kg),group B received medium dose(0.75μg/kg),and group C received high dose(1.0μg/kg)].Dexmedetomidine was pumped within 10 minutes,and then dexmedetomidine was continuously pumped at the rate of 0.5μg/(kg·h)until the end of operation.Before the end of the operation,5 mg dezocine was injected intravenously in groups A,B and C,and the same dose of 0.9%sodium chloride injection was injected intravenously in Group D.The mean arterial pressure and heart rate before,immediately after and 10 minutes after tracheal intubation,the extubation time,recovery time,emergence agitation rate,postoperative analgesia satisfaction and incidence of postoperative anesthesia related complications were compared among the 4 groups.Results Compared with group D,the mean arterial pressure and heart rate of group A,B and C before,immediately after and 10 minutes after tracheal intubation were all lower than those of group D,and the differences were statistically significant(P<0.05),but there was no significant difference in mean arterial pressure and heart rate among the three groups(P>0.05);When the extubation time and recovery time were compared among the four groups,the difference was not statistically significant(P>0.05);The incidence of emergence agitation in group A,B and C was lower than that of group D and the postoperative satisfaction was higher than that of group D,and the differences were both statistically significant(P<0.05);No anesthesia r

关 键 词：不同剂量 右美托咪定 地佐辛 鼻内镜手术 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]