咪达唑仑和右美托咪定抑制七氟醚麻醉苏醒期躁动的对比观察

摘要

Objective To observe the roles of midazolam and dexmedetomidine in postoperative agitation after sevoflurane anes-thesia. Methods 180 patients aged from 25~60, underwent general anesthesia in Department of General Surgery of hour hospital were selected and randomly divided into group A, group B and group C with 60 cases in each according to digital table method. All patients were induced and maintained by sevoflurane-remifentanyl general anesthesia. 15 minutes before the end of the opera-tion, the patients in group A were intravenous administration dexmedetomidine 1μg/kg (5min), while group B with midazolam 0.05mg/kg, group C intravenous injection of 0.9% saline 10ml. The BP and HR were recorded at the time point of as soon as ad-ministration of drugs, 5 and 10 minutes after administration. The time of operation, anesthesia, postanaesthetic recovery and stay-ing in the recovery room was also been recorded. Scores on postoperative emergence agitation were accessed to calculate the effect of drugs. Results The time of postanaesthetic recovery and incidence of postoperative agitation in group A and group B were lower than those in group C (P<0.05), and those in group A were lower than those in group B (P<0.05). There were no significantly dif-ferences between the three groups of patients in the indexes of respiration and circulation during the operation (P>0.05), the differ-ences in operation time, anesthesia time and time of staying in the recovery room between the three groups were not statistically significant (P>0.05). Conclusion The effect of clinical dose of dexmedetomidine on sevoflurane-remifentanil general anesthesia e-mergence agitation is better than that of midazolam.%目的：观察咪达唑仑、右美托咪定对七氟醚全身麻醉术后躁动的作用。方法选取该院普外科全身麻醉手术病人180例，年龄25~60岁，按数字表法随机分为A组、B组、C组，每组60例，麻醉维持和诱导均采用七氟醚-瑞芬太尼。手术结束前15 min A组静脉推注右美托咪定1μg/kg（5 min)，B组静脉推注咪达唑仑0.05 mg/kg，C组静脉推注0.9%生理盐水10 mL,记录给药即刻、给药后5 min、给药后10 min患者血压、心率以及3组患者的手术时间、麻醉时间、苏醒时间、麻醉后苏醒恢复室时间、评估苏醒期躁动分级。结果A、B组患者麻醉苏醒时间、术后躁动发生率均低于C组患者，差异有统计学意义（P﹤0.05）,且A组患者麻醉苏醒时间、术后躁动发生率低于B组患者，差异有统计学意义（P﹤0.05）,3组患者手术期呼吸、循环的各项指标比较，差异无统计学意义（P﹥0.05），手术时间、麻醉时间及苏醒后恢复室时间，差异无统计学意义（P﹥0.05）。结论临床剂量右美托咪定对七氟醚-瑞芬太尼全身麻醉苏醒期躁动疗效效果优于咪达唑仑。