摘要
目的观察右美托咪定(Dex)对异氟醚麻醉患者围手术期躁动、寒战、苏醒延迟等不良反应的影响。方法择期行上腹部手术患者40例,随机分为两组:生理盐水对照组(C组)和右美托咪定组(D组)。D组麻醉诱导前给予右美托咪定0.8μg/kg,麻醉诱导后给予右美托咪定0.5μg/(kg·h)持续输注,C组同时给予等容量生理盐水。记录患者气管插管前(T_0)、气管插管后即刻(T_1)、气管拔管前(T_6)、气管拔管后即刻(T_7)的血流动力学指标和手术开始5 min(T_2)、30 min(T_3)、1 h(T_4)、手术结束时(T_5)异氟醚呼气末有效浓度及停异氟醚后苏醒时间、拔管后躁动、寒战等不良反应发生情况。结果 D组T_3、T_4、T_5时异氟醚呼气末浓度明显低于C组(P<0.05);停异氟醚后苏醒时间明显低于C组(P<0.05);气管插管和拔管时血流动力学波动小于C组(P<0.05);C组苏醒期有8例发生躁动,9例发生寒战,D组有2例躁动,3例寒战,D组有3例心率低于50次/min,给予阿托品处理后好转。结论右美托咪定可明显降低全麻患者异氟醚呼气末浓度,稳定围术期循环功能,加快苏醒,减少躁动、寒战等不良反应。
Objective To observe the influence of dexmedetomidine on isoflurane anesthesia in patients with perioperative agitation,chills,delayed awakening.Methods Forty patients who were accepted upper abdominal operation in isoflurane anesthesia were randomly divided into two groups：group D was given Dex loading 0.8 μg/kg for 10 min,maintenance 0.5μg/（kg·h）,group C was given the same capacity saline infusion.And then was injected of midazolam,sufentanyl,etomidate,rocuronium.Then patients were given tracheal intubation and mechanical ventilation.The concentration of isoflurane was adjusted according to bispectral index（BIS）.End-tidal isoflurane were continuously monitored at 5 min（T2）,30 min（T3）,1 h（T4） of operation and at the end of operation（T5）.HR and MAP were continuously monitored before and after tracheal intubation and extubation.Awakening time was recorded after stop using isoflurane.Adverse reactions were recorded after tracheal extubation.Results The end-tidal isoflurane concentration of group D were lower than that in group C（P〈0.05）.The time of awakening in group D was shorter than that in group C（P〈0.05）.Group D was able to well-control MAP and HR fluctuations caused by tracheal intrbation and extubation compared with group C.Conclusion Dex can decrease end-tidal isoflurane concentration,promote awakening,promote hemodynamic stability,and reduce adverse reactions.
出处
《中国现代医生》
2016年第3期110-112,116,共4页
China Modern Doctor
关键词
右美托咪定
异氟醚
吸入麻醉
躁动
寒战
Dexmedetomidine
Isoflurane
Inhalation anesthesia
Agitation
Chills
