摘要
目的 研究小剂量右美托咪定单次静脉滴注对全身麻醉(全麻)患者循环和苏醒质量的影响.方法 40例拟实施全麻的美国麻醉师协会(ASA)分级Ⅰ或Ⅱ级择期骨科手术患者,随机分为A组、B组,每组20例.两组患者均采用全麻,A组患者麻醉诱导后10 min时予以右美托咪定0.6μg/kg加入250 ml输液内,30 min滴完.B组患者麻醉诱导前予以负荷剂量1μg/kg右美托咪定,15 min泵注完,继以0.5μg/(kg·h)静脉泵注,手术结束前40 min停药.比较两组患者术中情况、不同时间平均动脉压(MAP)和心率(HR)、苏醒指标.结果 A组患者麻黄碱用量(6.04±2.74)mg、阿托品用量(0.31±0.26)mg均少于B组的(10.30±3.67)、(0.44±0.12)mg,差异具有统计学意义(P<0.05).术前1 d平静休息时最低值(T0)时,两组患者MAP和HR比较差异无统计学意义(P>0.05).拔管后15 min(T4)时,B组MAP低于本组T0时,且低于A组,差异具有统计学意义(P<0.05);插管后即刻(T1)、意识恢复(T2)、T4时,两组患者HR低于T0时,差异具有统计学意义(P<0.05);拔管(T3)时,两组患者HR高于本组T0时,差异具有统计学意义(P<0.05);T4时,A组HR高于B组,差异具有统计学意义(P<0.05).A组呼吸恢复时间、意识恢复时间和拔管时间均短于B组,差异具有统计学意义(P<0.05).两组苏醒期躁动程度(RS)评分、拔管后视觉模拟评分法(VAS)评分比较差异无统计学意义(P>0.05);B组患者拔管后Ramsay镇静(RSS)评分(3.8±1.2)分高于A组的(2.3±1.5)分,差异有统计学意义(P<0.05).结论 小剂量右美托咪定单次静脉滴注使用更方便,血压过低和心动过缓发生率更低,镇静程度适宜,具有与常规剂量类似的躁动少的效果,可以在临床麻醉工作中推广应用.
Objective To study the effect of single-dose intravenous drip of low-dose dexmedetomidine on circulation and recovery quality in patients undergoing general anesthesia.Methods A total of 40 patients scheduled for elective orthopaedic surgery under general anesthesia gradedⅠorⅡby the American Society of Anesthesiologists(ASA)were randomly divided into group A and group B,with 20 cases in each group.Both groups were given general anesthesia.In group A,dexmedetomidine 0.6μg/kg was added into 250 ml infusion 10 minutes after induction of anesthesia and dripped off within 30 min.Patients in group B received a loading dose of 1μg/kg dexmedetomidine before induction of anesthesia and were pumped out for 15 minutes,following intravenous injection at 0.5μg/(kg·h)and stopped 40 min before the end of the operation.Comparison was made on intraoperative situation,mean arterial pressure(MAP)and heart rate(HR)at different times,recovery indicators between the two groups.Results The dosage of ephedrine(6.04±2.74)mg and dosage of atropine(0.31±0.26)mg in group A were less than(10.30±3.67)and(0.44±0.12)mg in group B.Their difference was statistically significant(P<0.05).There was no significant difference in MAP and HR between the two groups at the lowest level(T0)at 1 d of rest before operation(P>0.05).At 15 min after extubation(T4),the MAP in group B was lower than that at T0 and group A of the same time,and their difference was statistically significant(P<0.05).Immediately after intubation(T1),consciousness recovery(T2)and T4,the HR in both groups was lower than that at T0,and their difference was statistically significant(P<0.05).At extubation(T3),the HR in the two groups was higher than those at T0,and the difference was statistically significant(P<0.05).At T4,the HR in group A was higher than that in group B,and the difference was statistically significant(P<0.05).The respiratory recovery time,consciousness recovery time and extubation time in group A was shorter than those in group B,and their difference was sta
作者
王兵
朱晓军
陆磊
徐春红
房鲁岩
WANG Bing;ZHU Xiao-jun;LU Lei(Department of Anesthesia,Taixing Second People’s Hospital,Taixing 225411,China)
出处
《中国实用医药》
2019年第30期10-12,共3页
China Practical Medicine
关键词
右美托咪定
小剂量
单次静脉滴注
Dexmedetomidine
Low-dose
Single-dose intravenous drip
