摘要
目的 评价右美托咪定对妇科腹腔镜手术患者七氟烷复合麻醉恢复质量的影响.方法 择期妇科腹腔镜手术患者80例,年龄45~62岁,平均年龄(48±5.4)岁.体重46~80kg,平均体重(65±5.2)kg,ASA分级Ⅰ或Ⅱ级.采用随机数字表法分为对照组(C组)和右美托咪定组(D组),各40例.常规麻醉诱导气管插管后行机械通气,麻醉维持:吸入七氟烷,间断静脉注射舒芬太尼和维库溴铵维持术中麻醉,维持BIS值45~55.常规麻醉诱导后,D组经10min静脉输注右美托咪定0.5mg/kg,随后以0.25μg/(kg·h)速率输注至手术结束前30min.分别于术毕(T0)、转入PACU时即刻(T1)、拔除气管导管前1min(T2)、拔除气管导管后1min(T3)和拔除气管导管后5min (T4)5个时点记录HR、MAP和SpO2;记录苏醒时间、拔除气管导管时间,记录拔除气管导管时呛咳、麻醉恢复期恶心呕吐、呼吸抑制和躁动的发生情况.结果 与T0时点比较;C组在T1、T2、T3、T4时点MAP和HR明显升高(t=2.44、3.66、3.52、3.00和2.69、4.70、3.09、2.91, P<0.05或P<0.01);D组仅在T2时点MAP和HR明显高于T0时点(t=2.58和3.14,P<0.05或P<0.01).与C组比较,D组在T1、T2、T3、T4时点MAP和HR降低(t=2.68、3.00、4.86、7.07和3.26、2.83、4.38、5.55,P<0.05或P<0.01);术中七氟烷用量明显减少(t=36.65,P<0.01);苏醒时间和拔除气管导管时间明显缩短,呛咳、恶心呕吐和躁动的发生率降低(t=6.24、6.72、5.00、5.165、5.165,P<0.05或P<0.01);呼吸抑制发生率差异无统计学意义(P>0.05).结论 常规麻醉诱导后静脉输注右美托咪定0.5μg/kg,随后以0.25μg/(kg·h)速率输注至手术结束前30min,可明显改善妇科腹腔镜手术患者七氟烷复合麻醉恢复质量.
Objective To observe the effect of Dexmedetomidine on awaking quality in patients undergoing gynecological laparoscopy with Sevoflurane compound anesthesia.Methods 80 Society of anesthesjologists physical status I or II patients underwent gynecological laparoscopy were divided into 2 groups(n=40),using a random number table:control group(group C)and Dexmedetomidine group(group D).Participants were 45~62 years old(average age of 48±5.4)and 46~80kg(average weight of 65±5.2kg).After induction of routine anesthesia and mechanical ventilation,both of the two groups inhaled Sevoflurane and injected sufentanil and vecuronium(keep BIS 45~55)in maintenance period.After that patients in group D were given one-off injection of Dexmedetomidine(0.5mg/kg)and continuous injection at the rate of 0.25μg/(kg·h)until 30min before the end of the operation.MAP,HR,SpO2 in different time points,the time of spontaneous awakening,extubation and adverse reactions were recorded.Result Compared with T0,the MAP and HR at other time points were higher significantly in group C(t=2.44,3.66,3.52,3.00,2.69,4.70,3.09,2.91,respectively,P<0.05 or P<0.01).The MAP and HR only at T2 were higher significantly in group D(t=2.58,3.14,respectively,P<0.05 or P<0.01).Compared with group C,the MAP and HR were shorter significantly atT1,T2,T3,T4(t=2.68,3.00,4.86,7.07,3.26,2.83,4.38,5.55,respectively,P<0.05 or P<0.01).The dosage of sevoflurane was decreased significantly during the operation(t=36.65,P<0.01).The time of awakening and extubation,the incidence of cough,nausea,vomiting and restlessness were decreased significantly(t=6.24,6.72,5.00,5.165,5.165,respectively,P<0.05 or P<0.01).There was no significant difference in the incidence of respiratory depression(P>0.05).Conclusion After induction of routine anesthesia,it can promote postoperative awaking in the patients undergoing gynecological laparoscopy with Sevoflurane compound anesthesia by one-off injection of Dexmedetomidine(0.5mg/kg)and continuous injection at the rate of 0.25μg/(kg·h)until 30min before the end of the operation.
出处
《浙江临床医学》
2019年第1期111-113,共3页
Zhejiang Clinical Medical Journal
关键词
右美托咪定
麻醉药
吸入
麻醉恢复期
妇科腹腔镜手术
Dexmedetomidine
Anaesthetic
Inhalation
Anesthesia recovery period
Gynecological laparoscopy
