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不同剂量右美托咪啶对甲状腺手术患者全身麻醉拔管期心血管反应的影响 被引量:26

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摘要 目的观察不同剂量右美托咪啶对甲状腺手术患者全身麻醉拔管期心血管系统及苏醒时间的影响。方法全身麻醉下行甲状腺手术患者120例,随机分为低、中、高剂量右美托咪啶组(D1、D2、D3组)和对照组(C组),每组30例。四组麻醉诱导及维持相同,手术结束前10 min停止吸入七氟醚,D1、D2、D3组分别予右美托咪啶0.25、0.5、1.0μg/kg缓慢静注10 min,C组以相同速率静注等量生理盐水。分别于麻醉诱导前(T0)、拔管即刻(T1)、拔管后5 min(T2)、拔管后10 min(T3)记录收缩压、舒张压、心率及睁眼时间、拔管时间、定向力恢复时间、恢复至Aldrete改良评分≥9分时间和术后躁动发生率、术后2 h内视觉模拟评分(VAS)最大值。结果拔管即刻及拔管后5、10 min时,D1组收缩压、舒张压、心率及术后躁动发生率、躁动程度和术后2 h VAS最大值均与C组相近(P均>0.05),D2、D3组收缩压、舒张压、心率均较同时点C、D1组显著降低,术后躁动发生率亦显著低于C组,躁动程度较C组显著减轻(P均<0.05)。D1、D2组患者睁眼时间、拔管时间、定向力恢复时间及Aldrete改良评分≥9分时间均与C组相近(P>0.05)。D3组患者拔管时间、定向力恢复时间及Aldrete改良评分≥9分时间较D2组显著延长(P均<0.05)。D2、D3组术后2 h VAS评分最大值较C、D1组显著降低。结论 0.5μg/kg的右美托咪啶静注可显著减轻甲状腺手术患者麻醉苏醒期及拔管期心血管系统反应,不延长术后苏醒时间和拔管时间,同时具有术后镇痛作用。
出处 《山东医药》 CAS 2012年第38期58-60,共3页 Shandong Medical Journal
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