右美托咪定预防全麻术后躁动和咽喉疼痛的研究

发布时间：2018-06-19 18:06

本文选题：右美托咪定 + 全麻　；参考：《苏州大学》2014年硕士论文

【摘要】：背景及目的：全身麻醉苏醒期间部分患者因各种刺激因素发生术后躁动（postoperative agitation）和（或）咽喉疼痛（throat pain）。程度严重时可对患者造成重大伤害。右美托咪啶（Dexmedetomidine，Dex）为新型、高选择性α2-肾上腺素能受体（α2AR）激动剂,具有剂量依赖性镇静、镇痛、抗焦虑、抑制交感神经及脑保护等多种作用,无呼吸抑制,可通过激动中枢神经系统α2受体最密集的区域——脑干蓝斑核（Locus Coeruleus）(负责调解觉醒与睡眠),引发并维持自然非动眼睡眠(NREM)状态,类似生理睡眠易唤醒,副作用少而轻。本研究拟通对照分组实验，分析右美托咪定在预防全麻术后躁动和咽喉疼痛方面的效果，为提高全身麻醉的安全性及舒适性提供参考及依据。方法：选取在上海市第八人民医院自2013年6月至2013年12月，接受气管插管全麻拟行腹部以下手术治疗的患者114例，通过随机数字表法将其分为观察组和对照组各57例。两组均采用相同的药物进行全身麻醉，观察组在手术结束前半个小时静脉泵入右美托咪定，对照组则静脉泵入相同体积的0.9%氯化钠注射液。对比两组患者恢复自主呼吸的时间和拔除气管插管时间以及术后躁动和咽喉疼痛的发生率。采用t检验、卡方检验对研究资料统计分析。结果：两组患者恢复自主呼吸时间、拔除气管插管时间的对比，差异没有统计学意义（P＞0.05）。在术后躁动方面，观察组0级的有53例，躁动率为7.02%；对照组0级的有34例，躁动率为40.35%。观察组躁动率显著低于对照组（P＜0.05）。在术后咽喉疼痛方面，观察组0级的有46例，咽喉疼痛率为19.30%；对照组0级的有30例，咽喉疼痛率为47.37%。观察组咽喉疼痛率率显著低于对照组（P＜0.05）。结论：右美托咪定对全麻术后躁动和咽喉疼痛具有良好的预防作用，同时不会呼吸抑制和延迟苏醒，值得在临床上推广应用。
[Abstract]:Background and objective: during general anaesthesia, some patients were restless postoperatively and / or throat pain due to various stimuli. Severe injuries can be caused to patients. Dexmedetomine Dexine is a novel and highly selective 伪 _ 2-adrenergic receptor (伪 _ 2ARR) agonist with dose-dependent sedation, analgesia, anti-anxiety, inhibition of sympathetic nerve and brain protection, and no respiratory inhibition. Locus Coeruleusus, the most dense area of 伪 _ 2 receptor in the central nervous system, is responsible for regulating arousal and sleep, causing and maintaining NREM, which is similar to physiological sleep, which is easy to awaken and has less side effects. The purpose of this study was to analyze the effect of dexmetomidine on the prevention of restlessness and larynx pain after general anesthesia in order to improve the safety and comfort of general anesthesia. Methods: from June 2013 to December 2013, 114 patients undergoing tracheal intubation under general anesthesia were selected and randomly divided into two groups: observation group (n = 57) and control group (n = 57). The two groups were anesthetized with the same drugs. The observation group received dexmetomidine half an hour before the end of operation, while the control group received 0.9% sodium chloride injection in the same volume. The time of spontaneous respiration, tracheal intubation and postoperative restlessness and larynx pain were compared between the two groups. T test and chi-square test were used to analyze the research data. Results: there was no significant difference in the time of spontaneous respiration and tracheal intubation between the two groups (P > 0.05). In terms of postoperative restlessness, there were 53 cases in the observation group (grade 0) and 34 cases in the control group (grade 0) with the restlessness rate of 7.02%, and the restlessness rate was 40.35% in the control group. The restlessness rate in the observation group was significantly lower than that in the control group (P < 0.05). In terms of postoperative laryngeal pain, there were 46 cases in the observation group with grade 0 and 19.30% in the control group, and 30 cases in the control group with a pain rate of 47.37. The rate of throat pain in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: dexmetomidine has a good preventive effect on restlessness and laryngopharyngeal pain after general anesthesia without respiratory inhibition and delayed recovery. It is worth popularizing in clinic.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

【参考文献】