摘要
目的评价帕瑞昔布钠联合右美托咪定对全身麻醉开胸手术患者麻醉恢复期躁动的影响。方法采用随机数字表法,将其分为4组,每组40例:帕瑞昔布钠组(P组)、右美托咪定组(D组)、帕瑞昔布钠联合右美托咪定组(PD组)和对照组(N组)。P组:术前30 min帕瑞昔布钠40 mg静脉注射,D组:术前30 min给予等量生理盐水术毕前5 min给予右美托咪定0.5μg/kg缓慢静脉注射,PD组术前30 min帕瑞昔布钠40 mg静脉注射及术毕前5 min给予右美托咪定0.5μg/kg缓慢静脉注射,N组术前及术毕前均给予等容量生理盐水。记录麻醉苏醒时间(麻醉结束至呼之睁眼的时间)和气管拔管时间(麻醉结束至拔除气管导管的时间)。记录麻醉诱导前(T0)、术毕(T1)和拔除气管导管后即刻(T2)患者血糖浓度,血浆肾上腺素和去甲肾上腺素的浓度。记录麻醉恢复期患者躁动的发生情况,并评价躁动程度。并观察恢复期患者有无呼吸抑制、苏醒延迟、恶心、呕吐等不良反应。结果 4组间苏醒时间、拔管时间比较差异无统计学意义。与T0时比较,4组T1和T2时血糖浓度和血浆皮质醇、肾上腺素和去甲肾上腺素的浓度升高(P<0.05);与N组比较,P组、D组和PD组T1和T2时血糖浓度和血浆皮质醇、肾上腺素和去甲肾上腺素的浓度降低(P<0.05);与P组和D组比较,PD组T1和T2时血糖浓度和血浆皮质醇、肾上腺素和去甲肾上腺素的浓度降低(P<0.05)。P、D、PD3组患者躁动评分、发生率明显低于N组(P<0.05),而PD组又明显低于P组和D组(P<0.05)。4组的不良反应发生率差异无统计学意义。结论帕瑞昔布钠联合右美托咪定可以抑制全身麻醉患者麻醉恢复期的应激反应,降低躁动发生率及躁动程度,优于单一用药,进一步提高麻醉恢复期患者安全。
Objective To evaluate the influence of the combination of parecoxib sodium with dexmedetomidine on the agitation of anesthesia recovery period in patients with open thoracic surgery. Methods Random number table method was used. All cases were divided into four groups, 40 cases in each group： parecoxib sodium group （P group）, dexmedetomidine group （D group）, group of the combination of parecoxib sodium with dexmedetomidine （PD group） and control group （N group）. In the P group, parecoxib sodium was intravenously injected by 40 mg 30 minutes before surgery. In the D group, the equivalent saline was carried out 30 minutes before surgery, and 0.5 μg/ kg dexmedetomidine was intravenously injected 5 minutes before closure. In PD group, parecoxib sodium was intravenously injected by 40 mg 30 minutes before the surgery and 0.5 μg/kg dexmedetomidine was slowly injected 5 minutes before closure. The N group was given equivalent saline before the surgery and before closure. The anesthesia recovery time （the time from the end of anesthesia to open eyes） and time of tracheal extubation （the time from the end of anesthesia to extubation） were recorded. The concentration of the blood glucose, plasma epinephrine and norepinephrine of patient in the anesthesia induction （To）, end of the surgery （Tl） and the moment of extubation （T2） were recoeded. The occurrence of the agitation during anesthesia recovery period was recorded, and the degree of the agitation was evaluated. Respiratory depression, delayed awakening, nausea, vomiting and other adverse reactions were observed. Results There is no statistical difference of awaking time and extubation time between the four groups. Compared with the To, at the time of TI and T2, the concentration of the blood glucose and plasma cortisol, epinephrine and norepinephrine of four groups increased （P 〈 0.05）. Compared with the N group, at the time of T1 and T2, the concentration of the blood sugar and plasma cortisol, epinephrine and norepinephri
出处
《中国现代医学杂志》
CAS
北大核心
2016年第20期126-129,共4页
China Journal of Modern Medicine
关键词
帕瑞昔布钠
右美托咪定
开胸手术
躁动
parecoxib sodium
dexmedetomidine
thoracotomy
psychomotor agitation
