摘要
目的观察右美托咪定预防神经外科手术患者术后躁动的临床效果。方法选择神经外科全麻手术患者60例,随机均分为右美托咪定组(D组)和生理盐水组(C组)。患者手术结束前10min停用麻醉药,D组静脉泵注右美托咪定0.4μg/kg10min,C组静注等剂量的生理盐水。记录麻醉前、拔管即刻、拔管后5min血流动力学变化,并对拔管后5、30、60、120min躁动程度、镇静状态、躁动发生率进行评估。观察呼吸恢复时间、唤醒时间和拔管时间。结果与C组比较,D组拔管即刻及拔管后5min的MAP明显降低,HR明显减慢(P<0.05);与麻醉前比较,D组拔管后5min的MAP明显降低,HR明显减慢,C组拔管即刻及拔管后5min的MAP明显升高,HR明显增快(P<0.05)。D组麻醉苏醒期躁动发生率、躁动程度明显低于C组,D组VAS评分在拔管后5、30、60、120min均明显低于C组(P<0.05),Ramsay镇静评分拔管后5、30min明显高于C组(P<0.05)。结论静脉泵注0.4μg/kg右美托咪定能减轻拔管期应激反应,减少躁动,不延迟呼吸恢复时间、唤醒时间和拔管时间,可预防神经外科全麻术后躁动。
Objective To observe thepreventive effect of dexmedetomidine on postoperative agitation with patients undergoing neurosurgery general anesthesia. Methods Sixty patients undergoing neurosurgery general anesthesia were randomly divided into two groups： group dexmedetomidine（group D）, and control group（group C）. Anesthetics were stopped 10 min before the end of operation. Patients in group D was given dexmedetomidine（0.4 μg/kg ）intravenously, while in group C was equal volume of saline. Hemodynamic changes were recorded before anesthesia, at the moment of extubation and 5 min after extubation respectively. The incidence of agitation and sedation scores were assessed at 5,30, 60,120 rain after extubation. The breathing recovery time, arousing time and extubation time were observed. Results MAP and HR were significantly decreased in group D than in group C at the moment of extubation and 5 min after extubation（P〈0.05）. Compared with before anesthesia, MAP was decreased and HR became slower significantly in group D at 5 min after extubation. MAP was increased and HR became faster in group C on the moment of extubation and 5 min after extubation （P〈0.05）. Compared with group C, the agitation incidence and level were lower in group D. The score of VAS were lower at 5,30,60,120 min after extubation and the score of Ramsay were higher at 5, 30 min after extubation in group D than in group C （P 〈 0. 05）. Conclusion The injection of dexmedetomidine （0. 4 μg/kg） with minipump can suppress extubation stress and relieve agitation, while did not prolong the breathing recovery time, arousing time and extubation time. Dexmedetomidine can prevent postoperative agitation of neurosurgery after general anesthesia.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2012年第9期885-887,共3页
Journal of Clinical Anesthesiology
基金
南京市医学科技发展项目(YKK10114)
南京医科大学面上项目(2010NJM074)
关键词
右美托咪定
术后躁动
神经外科
Dexmedetomidine
Postoperative agitation
Neurosurgery
