摘要
目的观察右美托咪定复合氟比洛芬酯对全麻患者苏醒期躁动及拔管期心血管反应的影响。方法择期行全身麻醉的口腔颌面部肿瘤手术患者80例,ASAⅠ或Ⅱ级,随机分为氟比洛芬酯组(F组)、右美托咪定组(D组)、右美托咪定复合氟比洛芬酯组(DF组)和对照组(C组),每组20例。F组于手术结束前30min经静脉注射氟比洛芬酯50mg;D组于手术结束前30min经静脉注射右美托咪定0.5μg/kg;DF组手术结束前30min经静脉注射氟比洛芬酯50mg,同时经静脉注射右美托咪定0.25μg/kg;C组静脉注射与D组等容量的生理盐水。记录四组患者拔管前(T0)、拔管时(T1)、拔管后5min(T2)MAP、HR的变化;记录苏醒时间、拔管时间以及拔管前Riker镇静躁动评分、拔管后5min的Ramsay镇静评分。结果 T1、T2时F组、C组MAP明显高于,HR明显快于T0时(P<0.05或P<0.01);D组、DF组MAP明显低于,HR明显慢于C组(P<0.01)。D组苏醒时间、拔管时间明显长于,Ramsay镇静评分明显高于其他三组(P<0.05);D组、DF组Riker镇静躁动评分明显低于C组(P<0.05);D组、DF组患者躁动发生率明显低于C组(P<0.05或P<0.01)。结论右美托咪定0.25μg/kg复合氟比洛芬酯50mg可有效降低全麻患者苏醒期躁动并能降低患者拔管期心血管反应,不会延长患者的苏醒时间和拔管时间。
Objective To evaluate the efficiency of dexmedetomidine combined with flurbiprofen axetil preventing agitation and reducing extubation reaction after general anesthesia. Methods Eighty patients, ASA Ⅰ or Ⅱ, scheduled for selective oral and maxillofaeial surgery were randomly divided into four groups, 20 patients in each group. 30 mins before end of the operation, patients intravenously received flurbiprofen axetil 50 mg （group F）, dexmedetomidine 0. 5 μg/kg （group D）, dexmedetomidine 0. 25μg/kg plus flurbiprofen axetil 50 mg （group DF）, normal saline （group C）, respectively. MAP, HR were recorded before extubation （T0）, extubation （T1）, 5 rains after extubation （T2）. The recovery time, extubation time, Riker sedation-agitation seore（RSAS）before extubation and Ramsay sedation score 5 min after extubation were observed. Results Compared with To, MAP, HR at T1, T2 in group C and group F were significantly increased （P（0.05 or P（ 0.01）, MAP, HR at T1 ,T2 in group D and group DF were significantly lower than those in group C （P〈0.01）. The recovery time, extubation time in group D were significantly longer than those in group C, group F and group DF（P〈0.05）. Ramsay scores in group D was significantly higher than other groups（P〈0. 05）. The incidence of agitation in group D and group DF were significantly lower than those in group C（P〈0.05 or P〈0.01）. Conclusion Dexmedetomidine 0.25 μg/kg plus flurbiprofen axetil 50 mg can effectively prevent agitation and reduce extubation cardiovascular reaction during recovery period, without the disadvantage of prolonging the recovery and extubation time.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2014年第6期528-531,共4页
Journal of Clinical Anesthesiology
关键词
右美托咪定
氟比洛芬酯
苏醒期躁动
Dexmedetomidine
Flurbiprofen axetil
Emergence agitation
