摘要
目的探讨右美托嘧啶(dexmedetomidine,Dex)用于七氟醚吸人全麻下老年胃肠肿瘤患者术后苏醒期预防寒战的效果与安全性。方法选择60例2011年06月~2012年05月在本院行胃肠肿瘤手术ASAI~Ⅱ级老年患者,随机均分为I组(Dex,n=30)和Ⅱ组(生理盐水,n=30)。两组麻醉诱导方法相同,插管成功后进行间歇正压通气;术中吸人七氟醚至缝合皮肤前30min。I组气管插管后静脉输注Dex0.5μg·kg-1·h-1至关腹前1h停药;Ⅱ组则静脉输注等容量生理盐水。观察记录两组麻醉时间、拔管时间、术中腹腔冲洗量、输液量、七氟醚用量、阿托品使用率、患者在PACU1h内意识状态和寒战发生情况。结果两组患者麻醉时间、拔管时间、术中腹腔冲洗量及输液量差异无统计学意义。I组术中七氟醚用量、寒战发生率明显低于Ⅱ组(P<0.05)。I组阿托品使用率和安静入睡者显著高于Ⅱ组(P<0.01)。结论 Dex可安全静脉泵注用于七氟醚吸入全麻老年胃肠肿瘤手术患者,能有效地预防术后发生寒战,不影响苏醒及拔管时间。
Objective To investigate the clinical effects and safety of dexmedetomidine （Dex） on prevention of the shiver during revival period of postoperative gastrointestinal tumors in elderly patients in general anesthesia with inhalation sevoflurane. Methods 60 elective patients who were from Jun.2011 to May.2012 in our hospital, ASA grade I^II, undergoing gastrointestinal tumors surgery under general anesthesia were randomly allocated to two groups with 30 cases each. Group I （n=30） received Dex 0.5ug/kg and group II （n=30） received the same volume normal saline. The Methods of anesthesia introduction were the same and proceeded IPPV after intubation in two groups. Anesthesia maintains： the patients inhaled 2%~5% sevoflurane until before 30 min suture wound skin. The patients of group I after intubation were pumped Dex 0.5 μg·kg-1·h-1 until before 1h suture abdomen skin and the patients of group Ⅱ were pumped the same volume normal saline at the same time. Anesthetic time、extubation time、wash volume in abdomen cavity、transfusion volume、sevoflurane dosage during operation、Atropine using rate、patients＇ consciousness in 1 hour and happened shiver circumstance during recovery room were observed and recorded. Results Anesthetic time、extubation time、wash volume in abdomen cavity and transfusion volume were not significantly different in the two groups（P〈0.05）.Sevoflurane dosage and shiver occur rate in group I were found lower than that in group Ⅱ （P〈0.05）.Atropine using rate and quiet fall asleep cases were found significantly higher in group I than those in groupⅡ （P0.01）. Conclusion It is safety to pump intravenous injection Dex for gastrointestinal tumors surgery in old aged patients in general anesthesia with inhalation sevoflurane. It can be effective in preventing postoperative shivering. It does not delay revival time and extubation time.
出处
《中国实用医药》
2013年第27期4-6,共3页
China Practical Medicine
关键词
右美托咪定
七氟醚
寒战
麻醉
全身
老年患者
胃肠肿瘤
Dexmedetomidine
Sevoflurane
Shiver
Anesthesia
General
Elderly patients
Gastrointestinal tumor
