摘要
目的观察右美托咪定联合地佐辛对胃肠手术全麻患者的血流动力学及苏醒期躁动的影响。方法选择2013年1月~2015年9月我院收治的120例胃肠手术全麻患者为研究对象,随机分为A、B、C3组,A组给予0.4μg/（kg·h）右美托咪定持续微量泵注,B组给予0.1 mg/kg地佐辛,C组给予相同剂量的右美托咪定及地佐辛。对比3组麻醉前（T0）、拔管时（T1）、气管拔管后5 min（T2）和气管拔管后10 min（T3）血流动力学指标和拔管时间、患者呼吸恢复时间、苏醒时间及苏醒期躁动情况。结果组内对比：与T0点对比,T1时间点时,3组收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）和心率（HR）均无显著变化（P〉0.05）;T2、T3时间点时,A、B组SBP、DBP、MAP、HR值明显上升（P〈0.05）,而C组SBP、DBP、MAP、HR值仍然无显著变化（P〉0.05）。组间对比：T0、T1时间点时,3组的SBP、DBP、MAP及HR对比,无统计学差异（P〉0.05）。T2、T3时间点时,A、B组的SBP、DBP、MAP、HR值明显高于C组（P〈0.05）,而A、B组间对比无统计学差异（P〉0.05）。3组的拔管时间、呼吸恢复时间及苏醒时间对比无显著性差异（P〉0.05）。A、B组的苏醒期Ramsay评分明显低于C组,而苏醒期躁动发生率明显高于C组（P〈0.05）。结论右美托咪定联合地佐辛可维持麻醉期间血流动力学平稳,有助于降低苏醒期躁动程度及发生率,值得临床推广应用。
Objective To investigate the effects of dexmedetomidine combined with dezocine on the hemodynamics and agitation of patients receiving general anesthesia during gastrointestinal surgery. Methods 120 cases receiving general anesthesia during gastrointestinal surgery between January 2013 and September 2015 were chosen as research objects and randomly divided into group A, B, and C. Group A was given continuous micro pump injection with 0.4 μg/（kg·h） dexmedetomidine; group B was given 0.1mg/kg dezocine; group C was given the same dosage of dexmedetomidine and dezocine. Comparison was made in the hemodynamic indexes before the anesthetic（T0）, at the time of extubation（T1）, 5 min after tracheal extubation（T2）, and 10 min after tracheal extubation（T3）, and the extubation time, respiratory recovery time, awakening time, and agitation during the awakening period among the three groups. Results In the contrast within groups, compared with the SBP, DBP, MAP, and HR at T0, those of the three groups at T1 had no significant changes（P〈0.05）; those of group A and B at T2 and T3 significantly increased（P〈0.05）, while those of group C still had no significant changes（P〈0.05）. In the contrast among the groups, the differences in the SBP, DBP, MAP, and HR at T0 and T1 were not significant（P〈0.05）; those indexes of group A and B at T2 and T3 were significantly higher than those of group C（P〈0.05）, while the differences between group A and B were not significant（P〈0.05）. There were no significant differences in the extubation time, respiratory recovery time, and awakening time among the three groups（P〈0.05）. The Ramsay scores during the awakening period of group A and B were signifncantly lower than those of group C, while the incidence of agitation during the awakening period of the former two groups was significantly higher than that in the latter one（P〈0.05）. Conclusion The dexmedetomidine combined with dezocine can maintain hemodynamic stability during the anesthesia, decrease the degree and incidence of agitation during the awakening period, which is worthy of clinical promotion.
出处
《西南国防医药》
CAS
2016年第4期361-364,共4页
Medical Journal of National Defending Forces in Southwest China
关键词
右美托咪定
地佐辛
胃肠手术
血流动力学
苏醒期躁动
麻醉
dexmedetomidine
dezocine
gastrointestinal surgery
hemodynamics
agitation during awakening period
anesthesia
