摘要
目的观察丙泊酚序贯右美托咪定对成人患者苏醒期躁动(EA)的治疗效果。方法气管插管全身麻醉后发生EA、RASS评分≥2分的成人患者40例,采用数学表法随机分为丙泊酚序贯右美托咪定组(A组)和丙泊酚组(B组),每组各20例。两组患者发生EA时,均立即经静脉给予丙泊酚0.5mg/kg,随后A组给予右美托咪定0.5μg/kg,微泵静脉注射10min;B组给予丙泊酚1mg/kg,微泵静脉注射10min。经上述治疗后若患者仍有躁动表现,则予丙泊酚0.5mg/kg静脉注射,直至RASS评分=0分或患者无躁动、可正常交流。结果两组患者治疗前RASS评分无差别(P>0.05)。与B组相比,A组患者EA治疗时间、PACU停留时间显著缩短,苏醒期丙泊酚额外用量减少,差异有统计学意义(P<0.05)。两组患者EA均得到有效治疗,治疗期间无心律失常、呼吸抑制等并发症发生。术后24h随访时,两组患者均对EA期间无不良记忆,满意度高,差异无统计学意义(P>0.05)。结论丙泊酚序贯右美托咪定可有效地治疗苏醒期躁动,有缩短EA治疗时间及PACU停留时间,减少额外镇静药物用量的优势,更适于全身麻醉后EA的治疗。
Objective To observe the effects of dexmedetomidine combined with propofol in emergence agitation during recovery after general anesthesia in adult patients. Methods Forty patients, with RASS score ≥2, suffering from emergence agitation after general anesthesia, were randomly assigned to dexmedetomidine combined with propofol group（group A, n=20） and propofol group（group B, n=20）. Patients in group A were administered with dexmedetomidine at a dose of 0.5μg/kg in 10mins, whereas patients in group B received intravenous propofol at a dose of 1mg/kg in 10mins, respectively. If patients still agitate after above treatment, intravenous propofol 0.5mg/kg was used for further treatment until RASS score=0, patients attain calm state. Results The time to RASS=0, the time to PACU discharge were shorter in group A compared with group B（P〈0.05）; The postoperative, supplemental propofol medication were significantly decrease in group A compared with group B（P〈0.05）.Arhythmia and respiratory depression didn＇t happen in this study. None patients had bad memories of the emergence agitation period, there were no significant differences between two groups in patient＇s satisfaction degrees（P〉0.05）. Conclusion Dexmedetomidine combined with propofol can effectively treat the emergence agitation, can shorten the time to RASS=0 and the time to PACU discharge, reduce the dosage of supplemental sedative drug. Dexmedetomidine combined with propofol was more beneficial than propofol in treatment for emergence agitation.
出处
《医学研究杂志》
2017年第2期55-58,共4页
Journal of Medical Research
基金
国家临床重点专科军队建设项目
上海青年医师资助计划项目(20141093)
