摘要
目的比较和分析右美托咪定与布托啡诺预防妇科腹腔镜手术患者术后苏醒期发生寒颤的效果。方法选取择期行全麻妇科腹腔镜手术的患者120例,随机分为右美托咪定组(D组)、布托啡诺组(B组)、生理盐水组(N组)三组,每组40例。手术结束前30min,D组:予右美托咪定0.5μg/kg+生理盐水配制成20 ml;B组:予布托啡诺1 mg+生理盐水配制成20 ml;N组:予等容量生理盐水;静脉缓慢泵注10 min。记录主要结局指标:患者术后苏醒期寒颤的发生率。记录次要结局指标:包括患者手术前(T_(1))、手术结束时(T_(2))、拔管时(T_(3))、拔管后5 min(T_(4))平均动脉压(MAP)和心率(HR);患者术后2 h疼痛视觉模拟评分(VAS);患者恶心、呕吐、心动过缓、头晕和呼吸抑制等不良反应发生率。结果D组术后寒颤发生率是15%,B组是30%,N组是52.5%;D组和B组寒颤发生率明显低于N组,差异有统计学意义(P<0.05);D组和B组寒颤发生率差异无统计学意义(P>0.05)。与T_(1)时点比较,T_(2)时点:D组和B组MAP与HR明显下降,差异有统计学意义(P<0.05);T_(3)时点和T_(4)时点:D组MAP与HR明显下降,差异有统计学意义(P<0.05)。T_(2)时点~T_(4)时点:D组MAP与HR明显低于B组和N组同时点,差异有统计学意义(P<0.05)。术后2 h VAS评分D组和B组明显低于N组,差异有统计学意义(P<0.05)。D组心动过缓发生率明显高于B组和N组,差异有统计学意义(P<0.05)。结论右美托咪定与布托啡诺均可有效预防妇科腹腔镜手术患者术后苏醒期的寒颤,效果相似且无明显不良反应,但右美托咪定术后苏醒期血流动力学更加稳定。
Objective To compare and analyze the preventive effect of dexmedetomidine and butorphanol on postoperative shivering in patients undergoing gynecological laparoscopic surgery.Methods One hundred and twenty patients with gynecological laparoscopic surgery under general anesthesia were randomly divided into dexmedetomidine group(group D),butorphanol group(group B)and normal saline group(group N),40 cases in each group.30 min before the end of surgery,group D:dexmedetomidine 0.5μg/kg+saline was prepared into 20 ml;Group B:butorphanol 1 mg+saline was prepared into 20 ml;Group N:an equal volume of saline;slowly injected for 10 min.Record main indicators:incidence of postoperative shivering.Record secondary indicators:including the mean arterial pressure(MAP)and heart rate(HR)of patient in preoperation(T_(1)),postoperation(T_(2)),immediate extubation(T_(3)),5 minutes after extubation(T_(4));pain two hours after surgery was assessed by a visual analogue scale;and the incidence of adverse reactions such as nausea,vomiting,bradycardia,dizziness and respiratory depression.Results There was no statistically significant different in postoperative shivering between group D and group B(P>0.05),but patients in the group N(52.5%)showed a significantly higher postoperative incidence of shivering than those in group D(15%)and group B(30%),with statistically significant difference(P<0.05).Compared with T_(1),at T_(2) time point:MAP and HR in group D and group B decreased significantly,with statistically significant difference(P<0.05);at T_(3) and T_(4) time point:MAP and HR in group D decreased significantly,with statistically significant difference(P<0.05).At T_(2)~T_(4) time point:MAP and HR in group D were significantly decreased than those in group B and group N,with statistically significant difference(P<0.05).The two hours after surgery VAS of group D and B was significantly lower than that of group N,with statistically significant difference(P<0.05).The incidence of bradycardia in group D was significantly higher than that in group B and group N,with statistically significant difference(P<0.05).Conclusion Both dexmedetomidine and butorphanol can effectively prevent shivering during postoperative awakening in gynecological laparoscopic surgery under general anesthesia,with similar effects and no obvious adverse reactions.However,dexmedetomidine is more stable in hemodynamics during postoperative awakening.
作者
许晓玲
杨博
吕秀云
徐翔
XU Xiao-ling;YANG Bo;LV Xiu-yun(Cancer hospital of Shantou university medical college,Shantou 515000,China)
出处
《中国处方药》
2023年第1期107-110,共4页
Journal of China Prescription Drug
关键词
寒颤
右美托咪定
布托啡诺
全麻
妇科腹腔镜
Shivering
Dexmedetomidine
Butorphanol
General anesthesia
Gynecological laparoscopic
作者简介
通信作者:徐翔,Email:xuxiang716@sina.cn。
