摘要
目的探讨右美托咪定复合靶控输注异丙酚-瑞芬太尼用于鼻内镜手术的效果。方法选取择期全身麻醉下行鼻内镜鼻窦开窗术患者80例,ASA分级Ⅰ或Ⅱ级,采用随机数字表法将其分为生理盐水对照组(C组,n=40)和右美托咪定组(D组,n=40)。麻醉诱导前(T0)15 min,D组静脉注射右美托咪定负荷剂量1.0μg·kg-1,继而以0.5μg·kg-1·h-1的速率维持至术毕;C组给予等容量生理盐水。于T0、诱导后即刻(T1)、诱导后20 min(T2)及术毕(T3)时记录心率(HR)、平均动脉压(MAP)、脉搏氧饱和度(SpO2)和警觉镇静评分(OAA/S评分);记录手术时间、异丙酚和瑞芬太尼用量、苏醒时间及不良反应发生情况,并由外科医生按Fromme术野质量评分表进行术野评分(SSFQ评分)。结果与C组比较,D组T1-T3时HR、MAP降低,OAA/S和SSFQ评分降低,异丙酚和瑞芬太尼用量减少,苏醒时间缩短(均P<0.05);SpO2,手术时间,呼吸抑制、心动过缓、恶心呕吐及低血压等不良反应发生率差异无统计学意义(均P>0.05)。结论右美托咪定复合靶控输注异丙酚-瑞芬太尼用于鼻内镜手术血流动力学更稳定,可安全、有效地用于鼻内镜手术。
Objective To investigate the clinical efficacy of dexmedetomidine combined with target-controlled infusion （TCI） of propofol and remifentanil for endoscopic sinus surgery. Meth- ods Eighty ASA I or II patients scheduled for elective endoscopic sinus surgery were randomly divided into control group（group C） and dexmedetomidine group（group D）, with 40 patients in each group. Group D was given intravenous injection of dexmedetomidine（1.0 μg kg-1） at 15 minutes before induction of anesthesia, followed by infusion of dexmedetomidine（0.5μg kg-1 h-1） until the end of surgery. Group C was given an equal volume of normal saline. Heart rate （HR）, mean arterial pressure （MAP）, oxygen saturation （SpO2） and observer＇ s assessment of alertness/sedation（OAA/S） scores were determined before anesthesia induction（T0 ） ,immediately afterinduction（T1）,20 minutes after induction（T2） and at the end of surgery（T3）. Operation time, consumption of propofol and remifentanil, awakening time and adverse reactions were recor- ded. Moreover,scores of surgical field quality（SSFQ） were assessed according to Fromme opera- tive field score table. Results Compared with group C,HR,MAP,OAA/S scores,SSFQ,awakening time and consumption of propofol and remifentanil significantly decreased in group D（P〈 0.05）. No significant differences were found in SpO2 ,operation time and side effects（respiratory depression, bradycardia, nausea, vomiting and hypotension） between the two groups （P 〉 0.05）. Conclusion Dexmedetomidine combined with TCI of propofol and remifentanil results in more stable hemodynamics and is safe and effective for endoscopic sinus surgery.
出处
《南昌大学学报（医学版）》
CAS
2013年第10期62-65,共4页
Journal of Nanchang University：Medical Sciences
关键词
右美托咪定
异丙酚
瑞芬太尼
靶控输注
鼻内镜手术
dexmedetomidine
propofol
remifentanil
target-controlled infusion
endoseopic sinus surgery
