右美托咪定联合复方利多卡因乳膏预防胸科手术后全麻苏醒期躁动和尿管刺激反应

发布时间：2018-04-06 07:01

本文选题：右美托咪定　切入点：利多卡因　出处：《中国新药与临床杂志》2017年11期

【摘要】：目的观察右美托咪定联合复方利多卡因乳膏预防男性患者胸科手术后苏醒期躁动和尿管刺激反应的临床效果。方法择期行开胸手术的男性患者100例,随机分右美托咪定组(D组)、利多卡因组(L组)、右美托咪定联合利多卡因组(DL组)和对照组(P组),每组25例。所有患者均在全麻后置入硅胶导尿管,D组和P组导尿管前端常规涂抹石蜡油,L组和DL组导尿管前端涂抹复方利多卡因乳膏。D组和DL组手术结束前30 min予右美托咪定1μg·kg~(-1)静脉泵注15 min,P组和L组相同方法给予氯化钠注射液。记录患者麻醉诱导前(T_0)、气管拔管即刻(T_1)和拔管后3 min(T_2)、10 min(T_3)、20 min(T_4)时的收缩压(SBP)、心率(HR)、血氧饱和度及拔管后患者躁动评分、疼痛VAS评分和尿道刺激症状程度。结果 T_1~T_4时D组和DL组SBP、HR低于L组和P组(P0.05),T_2~T_3时L组SBP、HR低于P组(P0.05)。D组、L组和DL组苏醒期躁动的发生率均低于P组(P0.05),而D组和L组间比较无显著差异(P0.05)。D组和DL组苏醒期VAS评分明显低于P组和L组(P0.05),L组与P组间比较无显著差异(P0.05)。尿管刺激反应发生率,D组、L组和DL组均低于P组(P0.05)。结论右美托咪定联合复方利多卡因乳膏可有效地预防、减轻男性患者胸科手术后全麻苏醒期躁动和尿管刺激反应,且不影响患者血流动力学和术后苏醒。
[Abstract]:Objective to observe the clinical effect of dexmetomidine combined with compound lidocaine cream in preventing restlessness and urethral stimulation in male patients after chest surgery.Methods 100 male patients undergoing elective thoracotomy were randomly divided into three groups: right metoimidine group (group D), lidocaine group (group L), dexmetomidine combined with lidocaine group (group D) and control group (n = 25).All patients were placed with silica gel catheter after general anesthesia, group D and group P were routinely smeared with paraffin oil on the front end of catheter catheter in group D and group D and group DL were applied with compound lidocaine cream 30 min before the end of operation. Group D and group DL were given dexmetomi 30 min before the end of operation.The injection of sodium chloride was given in group P and group L by intravenous injection of 1 渭 g KG-1 for 15 min.The systolic blood pressure (SBP), heart rate (HRT), oxygen saturation, restlessness score, pain VAS score and urethral irritation symptom were recorded before anesthesia induction, immediately after tracheal extubation and 3 min after extubation.The VAS scores of P group and L group were significantly lower than that of P group and L group. There was no significant difference between P group and P group (P 0.05).The incidence of urethral stimulation in group D was lower than that in group D and group DL (P 0.05).Conclusion dexmetomidine combined with compound lidocaine cream can effectively prevent restlessness and urethral irritation during general anesthesia recovery in male patients after chest surgery and does not affect hemodynamics and postoperative recovery.
【作者单位】：深圳市龙岗区人民医院胸外科;深圳市龙岗区人民医院麻醉科;
【基金】：深圳市科创委科研项目(J20160422141605247)
【分类号】：R614

【相似文献】