右美托咪定复合纳布啡超前镇痛防治妇科腹腔镜手术患者全麻苏醒期躁动的效果  

Effect of preemptive analgesia with dexmedetomidine combined with nalbuphine on prevention and treatment of restlessness in patients undergoing general anesthesia during laparoscopic gynecological surgery

作　　者：张培冰 黄进强[1] 陈日胜[1] ZHANG Peibing;HUANG Jinqiang;CHEN Risheng(The People's Hospital of Gaozhou,Guangdong Province,Gaozhou 525200,China)

机构地区：[1]广东省高州市人民医院,525200

出　　处：《临床合理用药杂志》2022年第7期21-24,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察右美托咪定复合纳布啡超前镇痛防治妇科腹腔镜手术患者全麻苏醒期躁动的效果。方法选择2019年12月—2020年12月于广东省高州市人民医院择期行腹腔镜下全子宫切除手术患者60例,使用随机数字表法分为观察组和对照组,每组30例。2组患者均采用气管插管静脉全身麻醉,观察组患者在麻醉诱导前15 min持续静脉泵注右美托咪定0.5μg/kg,10 min静脉泵注完毕,而后静脉注射纳布啡10 mg,对照组则在同一时间点静脉注射等量生理盐水。比较2组拔管时间、恢复室停留时间、舒芬太尼应用例数,躁动评分、躁动发生率及拔管即刻、拔管后10 min、拔管后30 min镇静评分及48 h内不良反应。结果2组患者拔管时间、恢复室停留时间比较差异无统计学意义(P>0.05),观察组患者舒芬太尼静脉注射占比低于对照组(P<0.01)。观察组患者躁动发生率为10.00%,低于对照组的43.33%(χ^(2)=8.523,P=0.004)。观察组患者拔管即刻、拔管后10 min、拔管后30 min镇静评分高于对照组(P<0.01)。2组患者48 h内均未发生与麻醉相关的不良反应。结论右美托咪定复合纳布啡可降低妇科腹腔镜手术患者全麻苏醒期躁动发生率,发挥镇静作用且不延长拔管时间,减少舒芬太尼用量。Objective To observe effect of preemptive analgesia of dexmedetomidine combined with nalbuphine in the prevention and treatment of agitation in patients undergoing general anesthesia during laparoscopic surgery.Methods60 patients who underwent laparoscopic total hysterectomy in the People’s Hospital of Gaozhou,Guangdong Province from December 2019 to December 2020 were selected,and they were divided into observation group and control group by random number table method,30 cases in each group.Both groups were given general intravenous anesthesia,observation group received dexmedetomidine 0.5μg/kg by intravenous pump 15 minutes before anesthesia induction,the infusion was completed 10 minutes later,and 10 mg of nalbuphine after infusion of dexmedetomidine,control group received an intravenous injection of the same amount of normal saline at the same time.The time of extubation,residence time in recovery room,the number of cases requiring intravenous sufentanil,the agitation score,incidence of restlessness,the sedation scores immediately after extubation,10 minutes and 30 minutes after extubation,and adverse reactions within 48 hours were compared between the two groups.Results There was no significant difference in the time of extubation and stay in the recovery room between the two groups(P>0.05),the proportion of sufentanil in the observation group was significantly lower than that of the control group(P<0.01).The incidence of restlessness in observation group was 10.00%,which was significantly lower than 43.33%in control group(χ^(2)=8.523,P=0.004).The sedation scores of patients in observation group immediately after extubation,10 minutes after extubation,and 30 minutes after extubation were significantly higher than those in control group(P<0.01).There were no adverse reactions related to anesthesia in two groups within 48 hours.Conclusion Dexmedetomidine combined with nalbuphine can reduce the incidence of agitation in patients undergoing gynecological laparoscopic surgery during recovery period of general

关 键 词：右美托咪定 纳布啡 超前镇痛 腹腔镜手术 苏醒期躁动 

分 类 号：R614[医药卫生—麻醉学]