摘要
目的探讨右美托咪定对全身麻醉下老龄患者牙拔除术苏醒期躁动的影响。方法80例全身麻醉下行牙拔除术老龄患者随机分为试验组与对照组,分别于麻醉诱导前10 min静脉泵注右美托咪定0.5μg/kg和等容量0.9%氯化钠溶液。观察两组患者心率(HR)、平均动脉压(MBP)的变化,记录各组麻醉前(T0)、术毕拔管即刻(T1)、术毕拔管后5 min(T2)、术毕拔管后10 min(T3)、术毕拔管后30 min(T4)时点数值;统计两组患者自主呼吸恢复时间、苏醒时间和拔管时间;采用Riker镇静躁动评分测定患者拔管时及拔管后各时点的苏醒期镇静及躁动情况。结果两组患者T1~T4时点的HR、MBP高于同组T0时点,试验组T1~T4时点的HR、MBP均低于同时点对照组(P<0.05);两组患者苏醒期指标比较,差异无统计学意义(P>0.05);两组患者T2时点Riker镇静躁动评分均较T1时点降低,试验组T1、T2时点镇静躁动评分均低于同时间点对照组(P<0.05);试验组患者苏醒期躁动发生率低于对照组(P<0.05)。结论右美托咪定可有效预防全身麻醉下老龄患者牙拔除术麻醉苏醒期躁动的发生。
Objective To investigate effect of dexmedetomidine on prevention of emergence agitation in elderly patients undergoing tooth extraction.Methods Eighty elderly patients under general anesthesia were randomly divided into intervention group and control group with dexmedetomidine 0.5μg/kg and equal capacity 0.9%sodium chloride solution respectively by intravenous infusion in 10 min before anaesthesia induction.Heart rate and mean arterial pressure were recorded at pre-anesthesia(T0),extubation(T1),5 min(T2),10 min(T3),and 30 min(T4)after extubation.The times of spontaneous respiration recovery,consciousness regain and extubation were calculated,as well emergence agitation was recorded during peri-extubation by Riker sedation restlessness score.Results The HR and MBP at T1-T4 in each groups were higher than those at T0,the HR and MBP at T1-T4 in the intervetion group were lower than those of the control group(P<0.05).There was no significant difference in the time of spontaneous respiration recovery,consciousness regain and extubation between the two groups(P>0.05).The Riker score at T2 was lower than that at T1 in each groups,besides the score of intervention group were lower than those of control group at T1 and T2(P<0.05),and the incidence of emergence agitation of intervention group was lower than that of the control group(P<0.05).Conclusion Dexmedetomidine can reduce the incidence of emergence agitation in elderly patients undergoing tooth extraction in general anesthesia.
作者
郑良杰
陈超
ZHENG Liangjie;CHEN Chao(Department of Anesthesiology,Shantou Central Hospital,Shantou 515000,China)
出处
《中国医药指南》
2020年第22期85-86,共2页
Guide of China Medicine
