目的 探讨右美托咪啶对后腹腔镜手术患者术后苏醒期的影响.方法 选择50例ASA Ⅰ～Ⅱ级择期行后腹腔镜手术患者,采用随机对照方法分为实验组和对照组各25例.实验组患者在关气腹时给予右美托咪啶0.5 μg/kg微量泵泵注,10 min左右泵注完毕,对照组泵注等剂量的生理盐水作对照.观察患者停用麻药时(T0)、拔管时(T1)、拔管后5 min(T2)、拔管后10 min(T3)几个时段的平均动脉压(MAP)、心率(HR)变化,记录术毕患者自主呼吸恢复时间、呼之睁眼时间、拔管时间及术后警觉/镇静评分(OAA/S评分)和躁动情况.结果 实验组MAP、HR在拔管时、拔管后5 min明显低于对照组(P＜0.05),而且术后躁动发生率及OAA/S评分也明显低于对照组(P＜0.05)；但两组术毕自主呼吸恢复时间、呼之睁眼时间和拔管时间比较差异无统计学意义(P＞0.05).结论 右美托咪啶可有效抑制患者苏醒拔管期的应激反应,起到了良好的术后镇静作用,从而降低了苏醒期躁动发生率,提高苏醒质量.%Objective To investigate the effect of dexmedetomidine on postoperative recovery of patients after retroperitoneal laparoscopy. Methods Fifty patients of ASA Ⅰ - Ⅱ grade scheduled for retroperitoneal laparoscopy were randomly divided into two groups: the study group (n=25) and the control group (n=25). Patients in the study group were given micro infusion pump of dexmedetomidine 0.5 μg/kg for 10 min when closed pneumoperitoneum, while those in the control group were given the dose of saline. The change of mean arterial pressure (MAP) and heart rate (HR) were observed at drug withdrawal (To), extubation (T1), 5 min after extubation (T2), and 10 min after extuba-tion (T3). Spontaneous breathing recovery time, time to eye opening, extubation time, OAA/S score and restlessness were recorded. Results The MAP, HR in the study group was significantly lower than those in the control group at T1 and T2(P＜0.05), and the incidence of postoperative restlessness and OAA/S score in the study group were also significantly lower (P<0.05). There was no statistically significant difference between the two groups in spontaneous breathing recovery time, time to eye opening and extubation time (P>0.05). Conclusion Dexmedetomidine can inhibit extubation of the stress response effectively and produce a satisfactory postoperative sedation, which reduces the incidence of restlessness and improve the quality of recovery.
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