右美托咪定联合丙泊酚对腔镜下甲状腺手术患者苏醒时间及躁动程度的影响  

Effect of Dexmedetomidine Combined with Propofol on Recovery Time and Agitation Degree of Patients Undergoing Endoscopic Thyroid Surgery

作　　者：侯雅运 张昊曦 HOU Yayun;ZHANG Haoxi(不详;Department of Anesthesiology,Huai’an Hospital of Traditional Chinese,Huai’an 223001,China)

机构地区：[1]淮安市中医院麻醉科,江苏淮安223001

出　　处：《中国医学创新》2024年第21期69-73,共5页Medical Innovation of China

摘　　要：目的:探讨右美托咪定联合丙泊酚对腔镜下甲状腺手术患者苏醒时间及躁动程度的影响。方法:研究纳入2020年3月—2023年3月于淮安市中医院行腔镜下甲状腺手术的102例患者,按照随机数字表法分为对照组(n=51)和观察组(n=51),两组均予以瑞芬太尼和丙泊酚进行麻醉诱导,静脉注射罗库溴铵,麻醉维持使用丙泊酚和瑞芬太尼,观察组麻醉诱导前10 min静脉泵注右美托咪定。比较两组临床相关指标、疼痛程度[视觉模拟评分法(VAS)]、血流动力学[麻醉诱导前(T_(0))、气管插管后10 min(T_(1))、甲状腺切除时(T_(2))、气管导管拔除时(T_(3))的心率(HR)、平均动脉压(MAP)]、镇静效果、躁动程度。结果:两组自主呼吸恢复时间比较,差异无统计学意义(P>0.05);观察组苏醒时间、拔管时间均较对照组短,差异均有统计学意义(P<0.05)。术后1、6、12、24h,观察组VAS评分均较对照组低,差异均有统计学意义(P<0.05)。T_(1)、T_(2)、T_(3),观察组HR、MAP均较对照组低(P<0.05);观察组拔管后30 min、1 h的Ramsay镇静评分均较对照组高,苏醒期躁动评分较对照组低,差异均有统计学意义(P<0.05)。结论:右美托咪定联合丙泊酚应用于腔镜下甲状腺手术可以有效提高患者的苏醒质量,减轻术后疼痛,稳定血流动力学,提高镇静效果,并显著降低苏醒期躁动程度。Objective:To investigate the effect of Dexmedetomidine combined with Propofol on recovery time and agitation degree of patients undergoing endoscopic thyroid surgery.Method:This study included 102 patients who underwent endoscopic thyroid surgery in Huai’an Hospital of Traditional Chinese from March 2020 to March 2023,and they were divided into control group(n=51)and observation group(n=51)according to random number table method.Both groups were given Remifentanil and Propofol for anesthesia induction,Rocuronium Bromide was injected intravenously,Propofol and Remifentanil were used for maintenance of anesthesia,and Dexmedetomidine was injected intravenously 10 minutes before anesthesia induction in the observation group.Clinical related indexes,pain degree[visual analogue scale(VAS)],hemodynamics[heart rate(HR),mean arterial pressure(MAP)before anesthesia induction(T_(0)),10 min after tracheal intubation(T_(1)),at thyroid gland excision(T_(2)),tracheal tube removal(T_(3))],sedation effect and agitation degree were compared between the two groups.Result:There was no significant difference in the recovery time of spontaneous respiration between the two groups(P>0.05).The recovery time and extubation time of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05).At 1,6,12 and 24 h after operation,VAS scores in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).T_(1),T_(2),T_(3),HR and MAP in observation group were lower than those in control group(P<0.05).The Ramsay sedation scores in the observation group were higher than those in the control group at 30 min and 1 h after extubation,and the agitation score in the awakening period was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine combined with Propofol in endoscopic thyroid surgery can effectively improve the quality of recovery,reduce postoperative pain,stab

关 键 词：右美托咪定 丙泊酚 腔镜下甲状腺手术 苏醒时间 躁动程度 

分 类 号：R614[医药卫生—麻醉学]