右美托咪定在鼻腔及咽部手术后麻醉恢复期的应用

目的观察右美托咪定在鼻腔及咽部手术患者麻醉苏醒期的作用。方法鼻、咽部择期手术患者随机分为右美托咪定组和对照组,每组25例,2组麻醉方法相同。术毕入恢复室后右美托咪定组静脉缓注右美托咪定负荷量0.5μg.kg-1并以0.5μg.kg-1.h-1维持输注至拔气管导管,对照组给予等容量氯化钠注射液。比较2组麻醉时间、拔管时间、麻醉恢复室停留时间,入室、拔管和出室3个时间点的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、镇静评分(RSS)、麻醉后恢复评分(AS)、躁动-镇静评分(RASS)、疼痛评分(CPOT)等。结果 2组麻醉时间、拔管时间、恢复室停留时间无显著差异(P>0.05)。入室时2组MAP、HR和SpO2均无显著差异(P>0.05),拔管和出室时右美托咪定组MAP及HR均低于对照组(P<0.01)。2组患者的RSS和AS在3个时间点均无显著差异(P>0.05),拔管和出室时右美托咪定组的RASS和CPOT均低于对照组(P<0.01)。结论右美托咪定可减轻麻醉后恢复期躁动发生率、增强镇痛效果并稳定循环,促进平稳恢复。

Effect of dexmedetomidine on postanesthesia recovery in rhinal and pharyngeal surgical patients

AIM To investigate the effect of dexmedetomidine on postanesthesia recovery in rhinal and pharyngeal surgical patients.METHODS Selected rhinal and pharyngeal surgical patients were divided into dexmedetomidine group and control group randomly,for 25 patients in each group,and the same anesthesia was used in 2 groups.In postanesthesia care unit(PACU),0.5 μg·kg-1 loading dose and 0.5 μg·kg-1·h-1 maintained of dexmedetomidine were infused until extubation in dexmedetomidine group,and the equal volume of sodium chloride injection was injected in the control group.Mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO2),Ramsay sedation scale(RSS),Aldrete score(AS),Richmond agitation-sedation scale(RASS),and critical care pain observational tool(CPOT)were compared between two groups.RESULTS There were no significant differences in anesthesia time,extubation time,and the time stayed in PACU between two groups(P > 0.05).At the time of entering PACU,there were no significant differences in MAP,HR,and SpO2 between two groups(P > 0.05).When extubation and leaving PACU,MAP and HR in the dexmedetomidine group were significantly lower than those in the control group(P < 0.01).There were no significant differences in RSS and AS at 3 time points between two groups(P > 0.05).The RASS and CPOT at the time of extubation and leaving PACU in the dexmedetomidine group were significantly lower than the control group(P < 0.01).CONCLUSION Dexmedetomidine could decrease agitation,enhance analgesia,maintain stable circulation,and improve the recovery during postanesthesia convalescence.