右美托咪定不同用法在悬雍垂腭咽成形术患者全麻中的应用

发布时间：2018-01-15 12:27

本文关键词：右美托咪定不同用法在悬雍垂腭咽成形术患者全麻中的应用　出处：《山东医药》2015年20期 　论文类型：期刊论文

【摘要】：目的观察右美托咪定不同用法在悬雍垂腭咽成形术(UPPP)患者全麻中的应用效果。方法阻塞性睡眠呼吸暂停低通气综合征择期全麻下行UPPP患者120例,将患者随机均分为4组各30例:D1组为气管插管前15 min,静脉持续泵注右美托咪定0.5μg/kg至手术结束前30 min;D2组为手术结束前30 min,静脉持续泵注右美托咪定1μg/kg 15 min;D3组手术结束即刻静脉持续泵注右美托咪定1μg/kg,至患者苏醒拔管;对照组(C组)手术结束前10 min静脉注射曲马多2 mg/kg。记录入室(T0)、拔管前2 min(T1)、拔管即刻(T2)、拔管后2 min(T3)、进入麻醉恢复室10 min(T4)的HR、MAP、Sp O2,计算拔管时间,拔管后行Ramsay评分评估苏醒期躁动,PACU行VAS评估术后疼痛。结果与C组比较,D1、D2、D3组循环稳定,拔管时间延长,苏醒期躁动及术后疼痛发生率明显降低,P均0.05;与D1组比较,D2、D3组拔管时间缩短,D3组拔管时间最短,P均0.05;拔管质量评分比较,D1、D2、D3组拔管平稳,优于C组,D1、D2组优于D3组,P均0.05;苏醒期躁动及术后疼痛发生率D3组高于D1、D2组,P均0.05。结论全麻UPPP患者手术结束前30 min静脉持续泵注右美托咪定1μg/kg 15 min,拔管平稳,苏醒质量高。
[Abstract]:Objective to observe the different usage of dexmetomidine in uvulopalatopharyngoplasty (UPPP). Methods 120 patients with obstructive sleep apnea hypopnea syndrome were treated with UPPP under elective general anesthesia. All the patients were randomly divided into 4 groups (n = 30): 15 min before tracheal intubation, 0.5 渭 g / kg dexmetomidine by intravenous infusion until 30 min before the end of operation. Group D2 received intravenous infusion of dexmetomidine 1 渭 g / kg for 15 min at 30 min before the end of operation. In group D 3, intravenous continuous infusion of dexmetomidine 1 渭 g / kg was performed immediately after operation, and the patients recovered from extubation. Group C (n = 10) tramadol (2 mg / kg) was injected intravenously 10 min before the end of operation. Two minutes after extubation, HRMAP-SpO2 was entered into the anesthetic recovery room (10 mins, T4), and the extubation time was calculated. After extubation, Ramsay score was used to evaluate the postoperative pain of restless PACU in recovery phase. Results compared with group C, the circulation of group D _ 1 and D _ 2C was stable, and the time of extubation was prolonged. The incidence of restlessness and postoperative pain was significantly decreased by 0.05 in the recovery period. Compared with D1 group, the shortest extubation time of D2 + D3 group was shortened (P < 0.05), and the shortest extubation time of D3 group was significantly shorter than that of D _ 1 group (P < 0.05). The quality score of extubation was more stable than that of group D _ 1 and D _ 2 and D _ 2, and better than that of group D _ 1 and D _ 2 than that of group D _ 3 (P < 0.05). The incidence of restlessness and postoperative pain in group D _ 3 was higher than that in group D _ 1 and D _ 2. Conclusion the intravenous infusion of dexmetomidine 1 渭 g / kg for 15 min 30 min before the end of general anesthesia in UPPP patients had stable extubation and high recovery quality.
【作者单位】：天津市人民医院;
【分类号】：R614
【正文快照】： 阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种日益增多的全身性疾病,影响患者的生活质量和寿命。悬雍垂腭咽成形术(UPPP)是外科治疗OSAHS的最主要手段,属于高危手术。UPPP术后患者咽喉部疼痛很明显,苏醒期疼痛常引起患者躁动;术后呼吸道梗阻症状不会马上消失,过度镇静又会加

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