右美托咪定对全麻患者 i-gel 喉罩插入时应激反应的影响

摘要

目的：探讨右美托咪定对全麻患者i-gel喉罩插入时应激反应的影响。方法：将择期行腹腔镜下手术的120例患者随机分为治疗组与对照组（各60例），2组均给予喉罩插入下全麻，在麻醉诱导与维持期，治疗组给予右美托咪定辅助干预，对照组给予同等剂量生理盐水辅助干预。结果：2组的麻醉时间、呼吸恢复时间、呼之睁眼时间和拔出喉罩时间比较差异无统计学意义（P＞0．05）。 T1时间点治疗组的警觉／镇静（OAA／S）评分与Narcotrend指数（NI）明显下降，与对照组比较差异显著（P＜0．05），与T0时间点比较差异也有统计学意义（P＜0．05），T2时间点2组NI及OAA／S评分比较差异无统计学意义。治疗组的喉罩插入应激反应发生率明显低于对照组（1．3％ vs 10．0％，P＜0．05）。结论：腹腔镜下全麻患者采用i-gel喉罩插入具有很好的麻醉效果，右美托咪定能增强镇静作用，减少应激反应的发生。%Objective:To investigate the effect of dexmedetomidine on the stress response in general anesthetic patients under i-gel laryngeal mask intubation .Methods: One hundred and twenty patients with elective laparoscopic surgery were randomly divided into the treatment group and the control group (60 cases for each group), both groups were given laryngeal mask intubation general anesthesia .In the induction and maintenance period of anesthesia , the treatment group were received the supplementory dexmedetomidine , while the control group received the same dose of saline .Results:The time of anesthe-sia, respiratory recovery time, eye opening and extubation of the laryngeal mask time showed no significant differences in the two groups (P>0.05).The observer's assessment of alertness/sedation (OAA/S) scores and Narcotrend index (NI) were significantly decreased at T 1 time in treatment group , and there were significant differences compared with those of control group (P<0.05), and those of T0 time (P<0.05).There were no significant differences in OAA/S scores and NI at T2 time point between the two groups .The stress response rate of laryngeal mask intubation was obviously lower in the treatment group compared with that of control group (1.3% vs 10.0%, P<0.05).Conclusions: Laparoscopic anesthesia patients with i-gel intubation of laryngeal mask has good anesthesia effect , dexmedetomidine application can enhance the sedative effect, and reduce the incidence of stress response .