右美托咪定对颈吻食管癌手术患者麻醉苏醒期躁动的影响

发布时间：2018-06-07 13:23

本文选题：右美托咪定 + 躁动　；参考：《暨南大学学报(自然科学与医学版)》2015年04期

【摘要】：目的:评价右美托咪定对颈吻食管癌手术患者麻醉苏醒期躁动的影响.方法:择期行食管癌根治颈部吻合术患者60例,采用随机数字表法,将患者分为3组:对照组(N)组、研究组1(D1组)和研究组2(D2组),每组20例.麻醉诱导前,D1组患者静脉输注右美托咪定1μg/kg,输注时间为10 min,其后以0.3μg/kg/h持续输注至术毕;D2组患者以0.5μg/kg/h静脉输注右美托咪定至术毕;N组输注等量生理盐水.观察并记录清醒时(T1)、拔管即刻(T2)、拔管后10 min(T3)和拔管后30 min(T4)的镇静-躁动评分(SAS)和Ramsay镇静评分.记录心动过缓、低血压、低氧血症及术后恶心呕吐等并发症的发生率.记录麻醉清醒时间,拔管时间,拔管时有无呛咳躁动,拔管后是否配合指令.结果:各组麻醉清醒时间和拔管时间差异无统计学意义(P0.05).与N组比较,D1组和D2组患者术后SAS和Ramsay评分T1-T4各时点明显降低(P0.05).D1组和D2组躁动发生率及依从性与N组比较差异有统计学意义(P0.05),D1组和D2组间差异无统计学意义(P0.05).3组患者术后心动过缓、低血压、低氧血症和恶心呕吐的发生率差异均无统计学意义(P0.05).结论:右美托咪定用于食管癌颈吻手术围术期,有良好的镇静镇痛作用,两种给药方法都提高了患者的依从性,不给予负荷量、术中静脉匀速维持在临床使用上更方便简单,且对血流动力学影响更小.
[Abstract]:Aim: to evaluate the effect of dexmetomidine on restlessness during anaesthesia recovery in patients with cervical carcinoma of esophagus. Methods: sixty patients with cervical anastomosis of esophageal carcinoma were randomly divided into 3 groups: control group (n = 20), study group (1(D1) and study group (2(D2, n = 20). Before anesthesia induction, patients in group D 1 received dexmetomidine 1 渭 g / kg intravenously for 10 minutes, followed by continuous infusion of 0.3 渭 g/kg/h to group D 2 at the end of operation with 0.5 渭 g/kg/h intravenous infusion of dexmetidine to the same amount of normal saline in group N at the end of operation. The sedative-restlessness score (sas) and Ramsay sedation score were observed and recorded during waking, immediate extubation, 10 min after extubation and 30 min after extubation. The incidence of bradycardia, hypotension, hypoxemia and postoperative nausea and vomiting were recorded. Record anaesthesia awake time, any coughing or restlessness during extubation, whether to cooperate with instruction after extubation. Results: there was no significant difference in anesthesia awake time and extubation time in each group (P 0.05). Compared with group N, SAS and Ramsay scores of T1-T4 in group D 1 and group D 2 were significantly lower than those in group N. There was no significant difference in incidence and compliance of restlessness between group D 1 and group D 2. There was no significant difference between group D 1 and group D 2. Postoperative bradycardia, There was no significant difference in the incidence of hypotension, hypoxemia and nausea and vomiting (P 0.05). Conclusion: dexmetomidine has good sedative and analgesic effect in perioperative period of cervical anastomosis operation for esophageal carcinoma. Both of the two methods can improve the compliance of patients, do not give load, and maintain the uniform velocity of vein in the operation. And the effect on hemodynamics is less.
【作者单位】：河南省胸科医院麻醉科;
【分类号】：R614;R735.1

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