腹腔镜全子宫切除术中右美托咪定、帕瑞昔布钠联用对患者苏醒期躁动的预防效果

发布时间：2018-10-20 07:37

【摘要】：目的观察腹腔镜全子宫切除术全麻过程中右美托咪定、帕瑞昔布钠联合应用对苏醒期躁动的预防效果。方法全麻下行腹腔镜全子宫切除术的患者80例,随机分为D组、P组、DP组和C组,每组20例。D组、P组、DP组、C组分别于手术结束前30 min静注右美托咪定0.5μg/kg、帕瑞昔布钠40 mg、右美托咪定0.25μg/kg+帕瑞昔布钠40 mg及等量生理盐水。进行拔管前Riker镇静躁动评分观察苏醒期躁动发生情况(5~7分为躁动)。记录拔管后5 min的Ramsay镇静评分。观察并记录各组拔管前(T0)、拔管时(T1)、拔管后5 min(T2)的MAP、HR,苏醒时间,拔管时间。结果 D组、P组、DP组、C组分别有1(5%)、6(30%)、2(10%)、8(40%)例发生苏醒期躁动,D组、DP组苏醒期躁动的发生率低于C组、P组(P均0.05)。D组苏醒时间和拔管时间较其余三组延长,Ramsay镇静评分高于其余三组(P均0.05);C组和P组Riker镇静躁动评分高于D组、DP组(P均0.05)。与T0时比较,P组和C组T1、T2时MAP升高,HR加快(P均0.05);与C组比较,D组和DP组T1、T2时MAP降低,HR减慢(P均0.05)。结论腹腔镜全子宫切除术全麻过程中联合应用右美托咪定和帕瑞昔布钠能预防苏醒期躁动发生,稳定血压和心率,且不延长患者的苏醒时间和拔管时间。
[Abstract]:Objective to observe the preventive effect of dexmetomidine and paroxib sodium on restlessness during laparoscopic hysterectomy. Methods 80 patients undergoing laparoscopic hysterectomy under general anesthesia were randomly divided into D group, P group, DP group and C group. Group D, group P, group DP and group C were given dexmetomidine 0.5 渭 g / kg 30 min before operation, paroxib sodium 40 mg, dexmetoimidine 0.25 渭 g/kg, paroxib sodium 40 mg and saline. Riker sedative restlessness score before extubation was performed to observe the restlessness during recovery (57 patients divided into restlessness). The Ramsay sedation score of 5 min after extubation was recorded. The recovery time and extubation time of MAP,HR, before extubation (T0), during extubation (T1), 5 min after extubation (T2) were observed and recorded. Results 1 (5%), 6 (30%), 2 (10%), 8 (40%) cases occurred restlessness in group D, P, DP and C, respectively. The incidence of restlessness in group D and DP was lower than that in group C, and the recovery time and extubation time in group P were longer than those in the other three groups. Ramsay sedation score was higher in group D than in group C. The sedation and restlessness scores of Riker in the other three groups were higher than those in D group and DP group (P 0. 05, P 0. 05). Compared with T _ 0, MAP increased and HR increased at T _ 1T _ 2 in P group and C group, MAP decreased and HR decreased at T _ 1 T _ 2 in D group and DP group (all P 0.05). Conclusion combined use of dexmetomidine and paroxib sodium during laparoscopic total hysterectomy during general anesthesia can prevent restlessness, stabilize blood pressure and heart rate, and do not prolong the recovery time and extubation time of patients.
【作者单位】：三峡大学第一临床医学院;
【分类号】：R614.2

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