右美托咪定对妇科腹腔镜手术患者七氟烷复合麻醉恢复质量的影响

摘要

Objective To?observe?the?effect?of?Dexmedetomidine?on?awaking?quality?in?patients?undergoing?gynecological?laparoscopy?with?Sevoflurane?compound?anesthesia.?Methods 80?Society?of?anesthesjologists?physical?status?I?or?II?patients?underwent?gynecological?laparoscopy?were?divided?into?2?groups(n=40),using?a?random?number?table:control?group(group?C)and?Dexmedetomidine?group(group?D).Participants?were?45~62?years?old(average?age?of?48±5.4)and?46~80kg(average?weight?of?65±5.2kg).After?induction?of?routine?anesthesia?and?mechanical?ventilation,both?of?the?two?groups?inhaled?Sevoflurane?and?injected?sufentanil?and?vecuronium(keep?BIS?45~55)in?maintenance?period.After?that?patients?in?group?D?were?given?one-off?injection?of?Dexmedetomidine(0.5mg/kg)and?continuous?injection?at?the?rate?of?0.25μg/(kg·h)until?30min?before?the?end?of?the?operation.MAP,HR,SpO2?in?different?time?points,the?time?of?spontaneous?awakening,extubation?and?adverse?reactions?were?recorded.Result?Compared?with?T0,the?MAP?and?HR?at?other?time?points?were?higher?significantly?in?group?C(t=2.44,3.66,3.52,3.00, 2.69,4.70,3.09,2.91,respectively,P0.05). Conclusion After?induction?of?routine?anesthesia,it?can?promote?postoperative?awaking?in?the?patients?undergoing?gynecological?laparoscopy?with?Sevoflurane?compound?anesthesia?by?one-off?injection?of?Dexmedetomidine(0.5mg/kg)and?continuous?injection?at?the?rate?of?0.25μg/(kg·h)?until?30min?before?the?end?of?the?operation.%目的 评价右美托咪定对妇科腹腔镜手术患者七氟烷复合麻醉恢复质量的影响.方法 择期妇科腹腔镜手术患者80例,年龄45~62岁,平均年龄(48±5.4)岁.体重46~80kg,平均体重(65±5.2)kg,ASA分级Ⅰ或Ⅱ级.采用随机数字表法分为对照组(C组)和右美托咪定组(D组),各40例.常规麻醉诱导气管插管后行机械通气,麻醉维持:吸入七氟烷,间断静脉注射舒芬太尼和维库溴铵维持术中麻醉,维持BIS值45~55.常规麻醉诱导后,D组经10min静脉输注右美托咪定0.5mg/kg,随后以0.25μg/(kg·h)速率输注至手术结束前30min.分别于术毕(T0)、转入PACU时即刻(T1)、拔除气管导管前1min(T2)、拔除气管导管后1min(T3)和拔除气管导管后5min (T4)5个时点记录HR、MAP和SpO2;记录苏醒时间、拔除气管导管时间,记录拔除气管导管时呛咳、麻醉恢复期恶心呕吐、呼吸抑制和躁动的发生情况.结果 与T0时点比较;C组在T1、T2、T3、T4时点MAP和HR明显升高(t=2.44、3.66、3.52、3.00和2.69、4.70、3.09、2.91, P0.05).结论 常规麻醉诱导后静脉输注右美托咪定0.5μg/kg,随后以0.25μg/(kg·h)速率输注至手术结束前30min,可明显改善妇科腹腔镜手术患者七氟烷复合麻醉恢复质量.