右美托咪定对下肢手术患者血流动力学和术后恢复的影响

发布时间：2018-08-16 18:32

【摘要】：目的探讨右美托咪定对下肢手术患者的血流动力学和术后恢复的影响。方法选取上海长海医院2012年1—6月间300例行下肢手术患者为研究对象,将其按照随机数字法分入观察组和对照组,观察组患者在麻醉诱导成功后静脉注射1.0μg/kg右美托咪定,10min后以0.5μg·kg~(-1)·h~(-1)的速度经静脉泵持续注射;对照组患者静脉注射等量的0.9%氯化钠溶液。观察两组患者的血流动力学和术后恢复指标的变化。结果观察组在止血带充气前,止血带充气后15、30、45、60 min,以及止血带放气后5 min各时间点的心率均显著慢于对照组同时间点(P值均0.05);止血带充气后45、60min和止血带放气后5min各时间点的心输出量、心指数、每博输出量,以及止血带放气后5 min时的每博输出指数均显著高于对照组同时间点(P值均0.05)。两组间苏醒时间、拔除气管导管时间、离开手术室的时间的差异均无统计学意义(P值均0.05)。两组患者均发生恶心、呕吐、寒战、脉搏血氧饱和度异常、上呼吸道梗阻等并发症,但除对照组呕吐发生率显著高于观察组(P0.05)外,两组间其他不良反应发生率的差异均无统计学意义(P值均0.05)。观察组不良反应总发生率为5.3%(8/150),显著低于对照组的20.6%(31/150,P0.05)。结论临床中对于下肢手术患者术中应用右美托咪定麻醉是可行的,患者的血流动力学稳定,术后不良反应发生率也相对较低。
[Abstract]:Objective to investigate the effect of dexmetomidine on hemodynamics and postoperative recovery in patients undergoing lower limb surgery. Methods 300 patients undergoing lower extremity operation in Shanghai Changhai Hospital from January to June 2012 were selected and divided into the observation group and the control group according to the random number method. The patients in the observation group were continuously injected with 0.5 渭 g kg ~ (-1) h ~ (-1) after intravenous injection of 1.0 渭 g/kg dexmetidine 10 minutes after anesthesia induction, while those in the control group were given the same amount of 0.9% sodium chloride solution. The changes of hemodynamics and postoperative recovery index were observed in both groups. Results in the observation group, before the tourniquet was inflated, The heart rate of the tourniquet was significantly slower than that of the control group at each time point (P < 0. 05), and the cardiac output, cardiac index and output of 5min at each time point after the tourniquet inflated and the 5min after the tourniquet deflating were significantly slower than those of the control group at each time point (P < 0. 05) after the tourniquet was inflated and 5 min after the tourniquet exhalation (P < 0. 05). At 5 min after exhalation of tourniquet, the output index per beat was significantly higher than that in control group at the same time point (P < 0. 05). There was no significant difference in recovery time, trachea extubation time and time to leave the operating room between the two groups (P < 0.05). Nausea, vomiting, shivering, abnormal pulse oxygen saturation, upper respiratory obstruction and other complications occurred in both groups, but the incidence of vomiting in the control group was significantly higher than that in the observation group (P0.05). There was no significant difference in the incidence of other adverse reactions between the two groups (P 0.05). The total incidence of adverse reactions in the observation group was 5.3% (8 / 150), which was significantly lower than that in the control group (20.6%) (31 / 150) (P0.05). Conclusion it is feasible to use dexmetomidine in lower extremity surgery, the hemodynamics of patients is stable, and the incidence of postoperative adverse reactions is relatively low.
【作者单位】：上海长海医院麻醉科;
【分类号】：R614

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