摘要
目的探讨在静吸复合全身麻醉中应用右美托咪啶抑制苏醒期应激反应、减少并发症、提高患者的恢复质量的有效性及可行性。方法采用双盲研究,将60例患者随机分为实验组和对照组,所有患者均采用静吸复合全身麻醉,其中实验组在麻醉过程中泵注右美托咪啶,而对照组泵注生理盐水。记录苏醒期恢复过程(呼唤睁眼时间,拔管时间,完全清醒不再嗜睡时间)、苏醒期MAAS评分及VAS评分、血流动力学变化情况[麻醉前、拔管即时、拔管后30 min的心率(HR)、平均动脉压(MAP)]以及术后有无发生恶心呕吐、呼吸抑制等不良反应。结果两组患者呼唤睁眼时间、拔管时间、完全清醒不再嗜睡时间两组无显著性差异(P>0.05)。拔管后30 min VAS评分实验组较对照组明显降低(P<0.05)。拔管后5 min MAAS评分值实验组明显低于对照组(P<0.05)。两组患者麻醉前MAP、HR组间比较,差异无统计学意义(P>0.05);拔管即时、拔管后30 min与麻醉前比较,对照组MAP水平明显升高、HR明显增快(P<0.05),而实验组MAP、HR变化不明显(P>0.05);组间比较,拔管即时、拔管后30 min对照组MAP、HR均明显高于实验组(P<0.05)。对照组有7例患者出现寒颤而实验组所有患者均无出现寒颤,两组差异有统计学意义(P<0.05)。结论右美托咪啶能有效抑制静吸复合全身麻醉清醒期应激反应,减少并发症,提高患者的恢复质量,值得推广应用。
Objective To explore the validity and feasibility of inhibiting stress response,reducing complications and improving quality of recovery by using dexmedetomidine combined intravenous and inhalation anesthesia（CIIA）.Methods Sixty patients with CIIA were divided into 2 groups（experimental group and control group）with randomized double-blind study.Patients in experimental group were given with dexmedetomidine combined intravenous and inhalation anesthesia,while patients in control group were administrated with normal saline.The recovery process（awakening time,time for extubation,fully awakening time）and MASS scores and VAS scores of recovery period,changes in hemodynamics（HR,MAP in pre-anesthesia,the time for extubation and 30 min after anesthesia）,and adverse reactions（nausea and vomiting,respiratory depression） were recorded.Results There was no significant difference in age,weight,sex,duration of operation between these two groups（P0.05）.There was no significant difference in awakening time,time for extubation,fully awakening time between these two groups（P0.05）.VAS scores of 30 minutes post-anesthesia and MASS scores of 5 minutes after anesthesia were lower in experimental group than those of control group（P0.05）.There was no significant difference in MAP and HR before anesthesia between these two groups.HR was faster and MAP was higher in time for extubation,at 30min after anesthesia than pre-anesthesia in control group（P0.05）,while no difference in experimental group.Seven cases in control group had chill,and none in experimental group（P0.05）.Nausea and vomiting,respiratory depression were not occurred.Conclusion Dexmedetomidine can inhibit the stress response and reduce complications and improve the quality of recovery in patients with CIIA.It illustrates a good prospect for further application and recommendation.
出处
《临床和实验医学杂志》
2012年第13期1033-1035,共3页
Journal of Clinical and Experimental Medicine
关键词
静吸复合全身麻醉
右美托咪啶
苏醒质量
苏醒期
Dexmedetomidine
Endoscopic sinus surgery
Quality of recovery
Recovery period
Combined intravenous and inhalation anesthesia
