右美托咪啶复合曲马多对鼻窦手术拔管期不良反应的效果

发布时间：2018-06-01 08:53

本文选题：右美托咪啶 + 曲马多　；参考：《中国内镜杂志》2015年05期

【摘要】：目的观察小剂量右美托咪啶复合曲马多抑制功能性鼻内镜鼻窦手术(FESS)拔管期不良反应的效果。方法拟行FESS患者90例,随机分为A、B、C3组,每组30例,所有患者均采用气管内插管全身麻醉。手术结束前10 min,B组静脉注射右美托咪啶0.3μg/kg,C组静脉注射右美托咪啶0.3μg/kg和曲马多2 mg/kg,A组注射等量生理盐水。记录麻醉前(T0)、拔管即刻(T1)、拔管后5 min(T2)、10 min(T3)的MAP和HR,观察呛咳反应、VAS、Ramsay镇静评分和躁动评分,记录拔管期间高血压、低血压、心动过缓、低氧血症及术后恶心呕吐的发生率。结果 T1~T3时点,A组MAP和HR、B组MAP高于T0时点(P0.05),B、C组MAP、HR低于A组(P0.05),C组MAP低于B组(P0.05);B、C组呛咳反应、VAS、躁动评分低于A组(P0.05),C组VAS低于B组(P0.05)。结论 0.3μg/kg右美托咪啶复合2 mg/kg曲马多用于FESS术后拔管,可维持血流动力学稳定,减轻呛咳反应和躁动,提供良好术后镇痛。
[Abstract]:Objective to observe the effect of low dose dexmetidine combined with tramadol on the adverse reactions during extubation of functional endoscopic sinus surgery (FESS). Methods 90 patients with FESS were randomly divided into three groups, 30 cases in each group. All patients were anesthetized by endotracheal intubation. Ten minutes before the end of the operation, dexmetidine 0.3 渭 g / kg was injected intravenously in group B and dexmetidine 0.3 渭 g/kg was injected intravenously in group C, and the same amount of normal saline was injected in group A (2 mg / kg tramadol). The MAP and HRwere recorded before anesthesia, immediately after extubation, and 5 min after extubation, and 10 min after extubation. The sedation score and restlessness score of VAS-Ramsay during extubation were observed. The incidence of hypertension, hypotension, bradycardia, hypoxemia and postoperative nausea and vomiting during extubation were recorded. Results at T1~T3 time, MAP and MAP in group A and B were higher than those in group C at T0 time point. The MAP in group C was lower than that in group A (P 0.05) and MAP in group C was lower than that in group B (P 0.05). The score of restlessness in group A was lower than that in group A (P 0.05) and VAS in group C was lower than that in group B (P 0.05). Conclusion 0.3 渭 g/kg dexmetidine combined with 2 mg/kg tramadol for extubation after FESS can maintain hemodynamic stability, relieve cough reaction and restlessness, and provide good postoperative analgesia.
【作者单位】：暨南大学第二临床医学院附属深圳市人民医院麻醉科;
【基金】：深圳市科技计划项目(No:201203128)
【分类号】：R614.24

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