不同剂量右美托咪定对肺癌根治术患者苏醒期的影响

摘要

Objective To investigate the effects of the different effects of various doses of dexmedetomidine before the sternum closing on in term of agitation and circulaton during analepsia stage on patients undergoing lung resection for pulmomonary carcinoma. Methods Forty ASA(American Society of Anesthesiologists)Ⅰ~Ⅱpatients who were scheduled for radical resection of pulmomonary carcinomawere randomly divided into two groups to receive 1 μg/kg(4μg/m1) dexmedetomidine(observation group)or saline solution(control group)before the sternum closing. Record the SBP,DBP, HR,Restlessness Score(RS)during the recovery period. Results There was a significant difference in the incidence of emergence agitation between observation group and control group when endotracheal tube was removed(P<0.05). There was a significant difference in the blood presure,heart rate between these two groups at the time of extubation,as well as at 5 min and 10 min following extubation(P<0.05).Conclusion Using Single-dose of dexmedetomidine before the sternum closing, can relieve restlessness and modify cardiovascular response after general anesthesia on the patients with radical resection of pulmomonary carcinoma.%　　目的观察不同剂量右美托咪定对肺癌根治术患者全麻苏醒期间躁动及循环影响。方法根据美国麻醉师协会（ASA）体格情况分级，选择60例Ⅰ~Ⅱ级择期行肺癌根治术的患者，随机分为右美托咪定1组（D1）、右美托咪定2组（D2）和对照组（C组），D1组、D2组分别在手术关胸前经微泵持续静脉输注右美托咪定0.5μg/kg（4μg/m1）、1μg/kg（4μg/m1），输注时间15min，对照组持续输注同等容量生理盐水。观察三组在苏醒期躁动、循环情况及VAS评分情况。结果 D1、D2组术后躁动发生率和VAS评分显著低于对照组，差异有统计学意义（P<0.05），D2组围拔管期各时点的血压、心率等均显著低于对照组，差异有统计学意义（P<0.05或P<0.01）。结论关胸前1μg/kg（4μg/m1）右美托咪定可更好的减少肺癌根治术患者全麻苏醒期的躁动，缓解术后早期疼痛，维持血流动力学稳定。