术后右美托咪定持续输注对膝关节镜日间手术患者早期恢复质量的影响  

Impact of postoperative continuous infusion of dexmedetomidine on the quality of early recovery in patients undergoing ambulatory knee arthroscopy

作　　者：屠艳玲 李彩侠 陆姚[1,2] 刘学胜[1] 陈善桂[1] 程新琦[1,2] TU Yanling;LI Caixia;LU Yao;LIU Xuesheng;CHEN Shangui;CHENG Xinqi(Department of Anesthesiology,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,P.R.China;Day Surgery Center,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,P.R.China)

机构地区：[1]安徽医科大学第一附属医院麻醉科,合肥230022 [2]安徽医科大学第一附属医院日间手术中心,合肥230022

出　　处：《华西医学》2025年第2期217-222,共6页West China Medical Journal

基　　金：安徽医科大学重点项目(KJ2021A0278)。

摘　　要：目的探讨右美托咪定对膝关节镜日间手术患者全身麻醉术后早期恢复质量的影响。方法选择2024年6月—9月预约在安徽医科大学第一附属医院日间手术中心进行膝关节镜手术的患者。根据计算机生成的随机分配,将患者随机分为右美托咪定组(干预组)和生理盐水对照组(对照组)。干预组予0.04μg/(kg·h)右美托咪定持续输注至患者出院;对照组予同等剂量生理盐水持续输注至患者出院。观察指标为术后24 h健康相关生命质量EuroQol五维五水平量表评分,次要观察指标包括阿森斯失眠量表评分和术后24 h内恶心、呕吐等不良反应。结果共纳入患者60例,每组各30例。干预组和对照组在术后24 h健康效用值[(0.857±0.081)vs.(0.721±0.098)分]和手术当晚阿森斯失眠量表评分[2.00(2.00,3.00)vs.4.00(3.00,5.25)分]比较,差异均有统计学意义(P<0.05)。两组术后恶心呕吐发生情况差异无统计学意义[1例(3.3%)vs.5例(16.7%);χ^(2)=1.667,P=0.197]。两组均未发生心动过缓、低血压、尿潴留、呼吸抑制及头晕嗜睡等不良反应。结论右美托咪定可改善关节镜日间手术患者术后早期生活质量及睡眠质量,有利于术后早期康复。Objective To evaluate the effectivity of dexmedetomidine on the early postoperative quality of recovery in patients undergoing ambulatory knee arthroscopy under general anesthesia.Methods Patients scheduled for knee arthroscopy at the Day Surgery Center of the First Affiliated Hospital of Anhui Medical University between June and September 2024 were selected.According to the computer-generated random allocation,patients were randomly divided into the dexmedetomidine group(Dex group)and the saline control group(NS group).The Dex group received a continuous infusion of dexmedetomidine at a rate of 0.04µg/(kg·h)until discharge,whereas the NS group was administered a comparable volume of saline.The primary outcome measure was the EuroQol Five-Dimensional FiveLevel(EQ-5D-5L)score for health-related quality of life measured at the postoperative 24 hours.Secondary outcome measures included the Athens Insomnia Scale score on the night of surgery and the incidence of adverse reactions such as nausea and vomiting within 24 hours postoperatively.Results A total of 60 patients were included,with 30 patients in each group.There were statistically significant differences in the EQ-5D-5L health scores at the postoperative 24 hours(0.857±0.081 vs.0.721±0.098)and the Athens Insomnia Scale scores[2.00(2.00,3.00)vs.4.00(3.00,5.25)]on the night of surgery between the Dex group and the NS group(P<0.05).The difference in the incidence of postoperative nausea and vomiting between the two groups was not statistically significant[1 case(3.3%)vs.5 cases(16.7%);χ^(2)=1.667,P=0.197].No adverse reactions such as bradycardia,hypotension,urinary retention,respiratory depression,dizziness and lethargy occurred in both groups.Conclusion Dexmedetomidine can significantly improve the early postoperative quality of life and sleep in patients undergoing ambulatory knee arthroscopy,thereby facilitating early postoperative quality of recovery.

关 键 词：右美托咪定 日间手术 膝关节镜 早期生活质量 睡眠质量 

分 类 号：R614[医药卫生—麻醉学]