右美托嘧啶对胸腔镜手术全麻患者拔管期间的临床疗效观察

目的观察右美托嘧啶对胸腔镜肺叶切除术患者拔管期间的临床疗效观察。方法选择我院收治需要气管插管全麻行胸腔镜肺叶切除术的患者60例,分为右美托嘧啶组和对照组,各30例。两组分别在手术结束前30 min用静脉微泵注入0.5μg/kg·min的右美托嘧啶和等量的生理盐水,注射时间15 min。记录两组患者麻醉前、手术结束时、吸痰拔管时、拔管后1min、拔管后5 min、拔管后15 min各个时间点的心率、平均动脉压、Sp O2的变化,记录患者手术时间、睁眼时间、拔管时间、定向力恢复时间,记录拔管期间不良反应。结果右美托嘧啶组在吸痰拔管时、拔管后1 min、拔管后5 min的平均动脉压和心率与对照组比较降低明显(P0.05),拔管期间心动过缓的发生率右美托嘧啶组高于对照组(P0.05),寒颤发生率右美托嘧啶组低于对照组(P0.05),两组患者Sp O2、手术时间、睁眼时间、拔管时间、定向力恢复时间无差异。结论行气管插管全身麻醉的胸腔镜肺叶切除术患者在拔管前使用右美托嘧啶微泵注射,能有效抑制患者拔管期间的不良反应,保持循环及呼吸稳定,镇痛充分并不延长术后苏醒时间和拔管时间。

Effect of dexmedetomidine on extubation following the recovery from general anesthesia in the patients undergoing thoracoscopy operation

Objective To investigate the effect of dexmedetomidine（DEX）during general anes-thesia extubation on the patients receiving thoracoscopy operation. Methods Sixty patients scheduled for thoracoscopic lobectomy were divied into dexmedetomidine group and control group, 30 patients in each group. At 30 minutes before the end of procedure, the patients in dexmedetomidine group and con-trol group were given dexmedetomidine and 0.9% sodium chloride solution injection based on 0.5 g/kg · min, respectively. The recording physiological indicators included heart rate, blood pressure and blood oxygen saturation of the patient at the time of before operation, finishing operation, during extubation, 1 minute after extubation, 5 minute after extubation. And recording operation time, awake time, exbura-tion time, orientation recovery time and incidence of adverse reactions were also recorded. Results The heart rate and blood pressure of dexmedetomidine group were lower than that of control group at the time of during extubation, 1 minute after extubation, 5 minute after extubation （all P values<0.05）. More transient bardycardia and lower shiver occurred in dexmedetomidine group when compared to control group（P<0.05）. At time of extubation, there was no any significant difference in blood oxygen satura-tion, operation time, awake time, exburation time, orientation recovery time. Conclusions Dexmedeto-midine can constrain the adverse reactions and stable hemodynamic state with adequate pain relief, while no significant delaying of wawken and extubation time in patients undergoing thoracoscopic lobectomy.