摘要
目的探讨雷米芬太尼联合右美托咪定对头颈甲状腺手术患者安全性的影响。方法选取该院收治的135例头颈甲状腺手术患者作为临床研究对象,并随机分为A组(单纯芬太尼麻醉组)45例、B组(雷米芬太尼麻醉组)45例和C组(雷米芬太尼与右美托咪定联合麻醉组)45例。各组分别给予相应的麻醉药物,并比较和分析3组患者的麻醉、镇静改善,术后麻醉恢复,应激反应改善,不良反应的发生。结果 C组患者在T1、T2和T3时的脑电双频(BIS)指数分别为(97.02±2.03)、(52.53±3.64)和(57.00±4.81)分,与A、B组比较,评分均明显降低(P<0.05)。C组患者术后自主呼吸恢复时间(6.08±0.79)min,睁眼时间(7.35±0.42)min,拔管时间(8.26±0.51)min,均明显缩短(P<0.05)。C组患者在T1、T2和T3时的血清皮质醇(Cor)值分别为(130.57±21.43)、(133.23±22.70)和(135.18±25.26)ng/ml,血糖(Glu)值分别为(4.81±0.63)、(4.94±0.60)和(5.17±0.59)mmol/L,均显著降低(P<0.05),且各时间相对稳定无明显波动。C组患者不良反应的发生率降低,但差异无统计学意义(P>0.05),其不良反应总发生率则明显降低(P<0.05)。结论雷米芬太尼联合右美托咪定对改善头颈甲状腺手术患者麻醉、镇静效果,加速术后麻醉恢复,降低麻醉应激反应和不良反应具有极其重要的临床价值。
【Objective】 To study the effect of remifentanil combined with dexmedetomidine on the safety of patients with cranial thyroid surgery. 【Methods】 Totally 135 cases who received cranial thyroid surgery in our hospital were randomly divided into group A（pure fentanyl group）, group B（remifentanil anesthesia group）and group C（remifentanil combined with dexmedetomidine group） with 45 cases in each group. The improvement of analgesic and sedative situation, the recovery after anesthesia, the improvement of stress response, the incidence of adverse reactions of the patients in the three groups were compared and analyzed. 【Results】 The bispectral indexes（BIS） of the patients in the group C at T1, T2 and T3were（97.02 ± 2.03） points,（52.53 ±3.64） points and（57.00 ± 4.81） points, which were significantly decreased compared to those in the groups A and B（P 〈0.05）. After surgery, the spontaneous breathing recovery time, opening eye time and extubation time in the group C were significantly shortened compared to those in the groups A and B（P 〈0.05）. The Cor scores of the patients in the group C at T1, T2 and T3were（130.57 ± 21.43） ng/ml,（133.23 ± 22.70） ng/ml and（135.18 ± 25.26） ng/ml, Glu scores were（4.81 ± 0.63） mmol/L,（4.94 ± 0.60） mmol/L and（5.17 ± 0.59） mmol/L,which were significantly reduced（P 〈0.05）. There were no statistically significant differences in the postoperative complications such as movement, respiratory depression, bradycardia, nausea and vomiting among the three groups（P 〉0.05）, but the overall postoperative complication rate in the group C was significantly decreased（P 〈0.05）. 【Conclusions】 Remifentanil combined with dexmedetomidine has an important clinical value for improving anesthesia and sedative effects, accelerating the postoperative recovery, reducing stress response and adverse reactions of anesthesia.
出处
《中国现代医学杂志》
CAS
北大核心
2015年第17期62-65,共4页
China Journal of Modern Medicine
