丙泊酚联合右美托咪定对术后恢复期躁动患者的影响

发布时间：2017-12-31 00:40

本文关键词：丙泊酚联合右美托咪定对术后恢复期躁动患者的影响　出处：《广东医学》2016年21期 　论文类型：期刊论文

【摘要】：目的观察丙泊酚联合右美托咪定对术后躁动患者的影响。方法选择择期全麻术后恢复期发生躁动同时潮气量不足的患者40例,ASAⅠ~Ⅱ级,随机单盲分成两组(n=20):对照组单纯给予丙泊酚,首剂量0.5~1 mg/kg,静脉注射,之后根据情况可多次给药;观察组给予丙泊酚首剂量0.5~1 mg/kg,静脉注射,维持用右美托咪定,1μg/(kg·h),泵注10 min,之后根据情况可多次给予丙泊酚。记录患者入恢复室时(T0)、丙泊酚第1次给药前(T1)、给药后(T2)、拔管前(T3)及拔管后5 min(T4)的SAS评分及血压、心率、血氧饱和度,记录丙泊酚总给药量及给药次数,记录给药后至患者清醒拔管的时间及恢复室总停留时间;术后随访有无术中知晓情况。结果T3时对照组的心率及收缩压明显高于观察组,差异有统计学意义(P0.05),T5时对照组SAS评分明显高于观察组,差异有统计学意义(P0.05),对照组丙泊酚总给药量及给药次数明显大于观察组,差异有统计学意义(P0.05),对照组患者恢复室停留时间大于观察组,差异有统计学意义(P0.05)。结论对于发生恢复期躁动又未达到拔管条件的患者泵注小量右美托咪定是有效、可行的,推荐用法是在给予丙泊酚静脉注射后再泵注右美托咪定。
[Abstract]:Objective to observe the effect of propofol combined with dexmetomidine on postoperative restlessness. Methods 40 patients with restlessness and insufficient tidal volume after elective general anesthesia were selected. They were randomly divided into two groups: the control group was given propofol at the initial dose of 0.5 mg / kg, and was injected intravenously, then the drug could be given several times according to the situation. The first dose of propofol (0.5 mg / kg) was injected intravenously and maintained with dexmetomidine 1 渭 g / kg / kg / h for 10 min. After that, propofol can be given several times according to the situation. The patients were recorded when they entered the recovery room. Before and after the first administration of propofol, T1 and T2 were recorded. SAS score, blood pressure, heart rate, blood oxygen saturation, total dosage and times of administration of propofol were recorded before and 5 min after extubation. The time of extubation and the total residence time of recovery room were recorded. Results the heart rate and systolic blood pressure in the control group were significantly higher than those in the observation group at T3, and the difference was statistically significant (P 0.05). The SAS score in the control group was significantly higher than that in the observation group at T5, and the difference was statistically significant (P 0.05). The total dosage and times of administration of propofol in the control group were significantly higher than those in the observation group. The difference was statistically significant (P 0.05). The recovery room residence time of the control group was longer than that of the observation group. Conclusion it is effective and feasible for patients with restless convalescence who do not reach the extubation condition to pump a small amount of dexmetidine. Recommended use is intravenous injection of propofol followed by intravenous injection of dexmetomidine.
【作者单位】：赣南医学院第一附属医院麻醉科;
【分类号】：R614
【正文快照】： 全麻手术苏醒期的躁动由多方面原因造成,如手术创伤大、出血多、术后伤口疼痛、留置导尿管等,常同时存在多种不良刺激,若处理不当,可引起严重并发症甚至危及生命。近年来右美托咪定在临床麻醉中广泛应用,相关研究发现围术期应用可预防并减少术后躁动的发生,但研究局限于术前或

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