右美托咪定持续静脉注射对七氟醚全麻患者恢复的分析

目的：观察右美托咪定持续静脉注射对七氟醚全麻患者恢复的影响。方法：全麻下行下腹部开腹手术患者40例,随机分入D组或C组,每组20例。常规诱导气管插管后,D组将右美托咪定以0.5μg/（kg·h）持续静脉注射;C组则以相同方法静脉注射0.9%氯化钠液,均在手术结束前30min停止。术中以七氟醚吸入维持麻醉,间断追加芬太尼和顺式阿曲库铵。记录患者麻醉恢复过程中血流动力学和呼吸变化,拔管及苏醒时间,术中七氟醚用量和不良反应发生情况。结果：与诱导前相比,在拔管前后C组平均动脉压（MAP）和心率（HR）均升高（P〈0.05）,而D组其波动少且拔管前后的差异无统计学意义（P〉0.05）;与D组相比,C组在术毕至拔管后3min的5个时间点上MAP和HR均显著升高（P〈0.01）。2组拔管及苏醒时间差异无统计学意义（P〉0.05）。D组术中七氟醚用量显著少于C组（P〈0.01）,未见苏醒期躁动发生（P〈0.05）。2组低血压和心动过缓发生率差异无统计学意义（P〉0.05）。结论：以0.5μg/（kg·h）持续静脉注射右美托咪定能使七氟醚全麻患者在恢复过程中血流动力学平稳,不延长拔管及苏醒时间,减少术中七氟醚用量,不良反应少。

Analysis of the Effects of Dexmedetomidine Continuous Intravenous Infusion on the Recovery Process of Patients with Sevoflurane Anesthesia

Objective： To study the Effects of continuous intravenous infusion with dexmedetomidine on the recovery process of patients with sevoflurane anesthesia.Methods： Forty patients undergoing lower abdominal surgery were randomly divided into either group： Group D（n=20） or Group C（n=20）.After anesthesia induction with fentanyl,propofol and cisatracurium,all patients were performed tracheal intubation and mechanical ventilation.Group D received dexmedetomidine infusion at a dose of 0.5 μg/（kg·h）,Group C received normal saline in the same way.Patients in both groups were discontinued at 30min before the end of the operation.Anesthesia was maintained with sevoflurane inhalation until the end of the operation,fentanyl and cisatracurium were given at 40min intervals.Mean arterial pressure（MAP）,heart rate（HR） and pulse oximetry（SpO2） were recorded during the recovery process.The durations from discontinuation of sevoflurane administration to spontaneous breath,eye-opening,extubation and orientation,the consumption of sevoflurane and the incidences of adverse effects were observed. Results ： Compared with the values before induction,MAP and HR of Group C increased at T2-5（P〈0.05）.Compared with Group D,MAP and HR in Group C were significantly higher at T1-5（P〈0.01）.The extubation and recovery times of the two groups were similar（P〈0.05）.The consumption of sevoflurane of Group D was significantly lower（P〈0.01）,the incidence of emergence agitation was also lower（P〈0.05）.There were no significantly differences in the incidences of hypotension and bradycardia between the two groups（P〈0.05）.Conclusions： As a general anesthetic adjuvant,dexmedetomidine infusion rate of 0.5 μg/（kg·h） may keep stable perioperative hemodynamics,reduce sevoflurane requirements and minimize the adverse effects without prolonging the extubation and recovery time.