右美托咪定在支气管介入手术全麻喉罩中的效果观察

摘要

Objective Toobservetheeffectofdexmedetomidineinlaryngealmaskalrwayundergeneralanesthe-sialnbronchialinterventionsurgery.Methods 52patientsunderwentlaryngealmaskalrwayundergeneralanesthesia in bronchial intervention surgery were randomly divided into dexmedetomidine group and control group with 26 patients in each group. 1. 0μg/kg dexmedetomidine was given intravenously with micro-pump 10 min before anesthesia in-duction. Drug administration rate was 0. 4~0. 6 μg/kg/h after induction until the end of surgery. Normal saline was given instead of dexmedetomidine in the control group. Heart rate( HR),arterial blood pressure,alrway pressure, ETCO2 and oxygen saturation( SpO2 )were recorded at the time of entering operation room( T0 ),before laryngeal mask alrway(T1),1 min after laryngeal mask alrway(T2),15 min in surgery(T3),stopping all drugs at the end of surgery( T4 ),and awakening when pulling out laryngeal mask( T5 ). Ramsay sedation score,body movement and coughreflexwererecordedbeforeandafterremovinglaryngealmask.Results HRandarterialbloodpressurede-creased after anesthesia induction and before insertion of laryngeal mask in both groups. HR and arterial blood pres-sure increased in T2,T3,T4 and T5 in the control group(P<0. 05). There was no significant difference between HR and arterial blood pressure in dexmedetomidine group(P>0. 05). Ramsay score in dexmedetomidine group was superior to that in the control group;Body movement and cough reflex were less in dexmedetomidine group( P<0. 05).Conclusion Dexmedetomidineinlaryngealmaskalrwayundergeneralanesthesialnbronchialinterventionsur-gery can provide a more stable anesthetic effect,malntaln stable hemodynamics and reduce adverse reactions without affecting breath and analepsia.%目的：观察右美托咪定在支气管介入手术全麻喉罩中的麻醉效果。方法选择支气管介入手术全麻喉罩患者52例，随机分为右美托咪定组和对照组，每组26例。右美托咪定组于麻醉诱导前10 min，用微量泵静脉给予右美托咪定负荷量1.0μg/kg ，静脉泵入10 min后开始麻醉诱导。之后输注速度设定为0.4~0.6μg/kg/h，直至手术结束。对照组用等量生理盐水代替右美托咪定静脉泵入。记录患者入室时的基础值（T0）、麻醉诱导插入喉罩前（T1）、插入喉罩后1 min（T2）、手术操作15 min（T3）、手术结束时停用所有麻醉用药（T4）和患者苏醒喉罩拔出时（T5）的心率（HR）、动脉血压、气道压、维持呼气末CO2（ETCO2）及血氧饱和度（ SpO2）。记录喉罩拔出前后的Ramsay镇静评分和体动呛咳反应。结果两组患者HR和动脉血压在麻醉诱导后插入喉罩前均下降。对照组患者HR和动脉血压在T2、T3、T4、T5时都明显升高，而右美托咪定组无明显变化，两组比较有统计学意义（ P<0.05）。术后右美托咪定组Ramsay镇静评分明显优于对照组，体动呛咳反应少于对照组，两组比较差异有统计学意义（ P<0.05）。结论右美托咪定在支气管介入手术中全麻喉罩可以提供更稳定的麻醉效果，维持血流动力学的平稳，并能减少不良反应且不影响呼吸及苏醒质量。