右美托咪定联合曲马多预防青壮年男性全麻病人苏醒期躁动评价

目的 观察右美托咪定用于预防青壮年男性全麻患者苏醒期躁动的效果和安全性.方法 选择60例18 ～ 45岁择期全麻手术的男性患者,随机分为3组:A组:全麻插管后静脉泵注右美托咪定1μg/kg,10 min后改为0.4 μg/(kg.h)至手术结束前30 min停药,缝皮前静注曲马多1 mg/kg;B组:术中泵注等量生理盐水,缝皮前静注曲马多2 mg/kg;C组:术中及缝皮前均给予等量生理盐水.记录3组患者T0-T4各时点的SBP、DBP、HR,记录3组患者的唤醒时间、拔管时间、拔管后5 min的躁动评分及不良反应.结果 3组患者在T0、T1时点SBP、DBP、HR差别无统计学意义；T2时点SBP、DBP、HR,A组明显低于B、C组(P＜0.01),T3时点SBP、DBP、HR,A、B组明显低于C组(P＜0.01),T4时点A组SBP、DBP、HR明显低于C组(P＜0.01),亦低于B组.B组SBP、DBP、HR低于C组(P＜0.05).3组患者唤醒时间、拔管时间差别无统计学意义,躁动评分A、B组明显低于C组(P＜0.01),且A组低于B组；术后24 h恶心呕吐的发生率A、C组低于B组(P＜0.05).结论 右美托咪定联合曲马多可有效提高青壮年男性全麻病人的复苏质量,且不增加复苏时间.两者合用可减少曲马多用量,减少术后恶心呕吐的发生.

The Clinic Study of Dexmedetomidine with Tramadol to Prevent the Agitation during Recovery Period from General Anesthesia in Young Male Patients

Objective To observe the efficacy and the safety of the Dexmedetomidine with tramadol to prevent the agitation during recovery period from general anesthesia in young male patient.Methods 60 young male patients undergoing the general anesthesia aged 18-45 were divided into three groups randomly.The patients in group A were given intravenous injection of 1 μg/(kg.h) with mini-pump for ten minutes after the intubation,then received intravenous injection of 0.4 μg/(kg.h) consistently till 30 minutes before the end of the operation,and received intravenous injection of the tramadol 1 mg/kg before the suturing.The patients in group B were given intravenous injection of the normal saline with the same dose and rate at the same time during the operation,and received intravenous injection of the tramadol 2 mg/kg before the suturing.The patients in group C were injected the normal saline with the same dose and rate during the operation and 30 minutes before the suturing.The SBP,DBP and HR scores were observed and recorded respectively from the T0-T4 among the three groups.The recovery time,extubation time,agitation scores 5 minutes after the extubation and the side effect were also recorded.Results No significantly differences in the SBP,DBP and HR scores were found at the time of T0 and T1 among the three groups.The SBP,DBP and HR scores in group A were obviously lower than group B and group C at the time of T2(P<0.01).The SBP,DBP and HR scores in group A and B were much lower than group C at the time of T3(P<0.01).The SBP,DBP and HR scores in group A were obviously lower than group B and group C at the time of T4(P<0.01)and the scores of group B were also lower than group C(P<0.05).No significantly differences were found in recovery time and extubation time among the three groups.But the agitation scores in group A and group B were obviously lower than group C(P<0.01)and the scores in group A were lower than group B.The post-operative nausea and vomiting(PONV)rate in group A and group C were lower than group B(P<0.05).Conclusions Dexmedetomidine with tramadol can effectively promote the quality of the recovery in the young male patients from the general anesthesia without the extension of the recovery time.It also can reduce the doses of the two medicine and decrease the incidence of postoperative nausea and vomiting.