右美托咪定对腹腔镜子宫切除术患者苏醒期的影响及护理配合

目的探讨全身麻醉中联合应用右旋美托咪定对腹腔镜下子宫全切术患者苏醒期的影响及护理要点。方法 40例择期腹腔镜下子宫全切术患者,ASA分级Ⅰ～Ⅱ级,随机分为右旋美托咪定组（D组,n=20）和对照组（C组,n=20）。全麻诱导前30min,D组静脉注射右旋美托咪定1μg/kg（0.9%生理盐水稀释,浓度为4μg/ml,用佳士比3500微量输注泵,10min内静脉泵注）;C组泵注同容量的生理盐水。气管插管静吸复合全麻。麻醉维持中,A组给予右旋美托咪定0.3μg·kg·h-1直至手术结束,对照组给予同等容量的生理盐水。记录两组患者拔管时间、拔管后15minOAA/S评分及躁动评分。结果两组患者拔管时间差异无统计学意义（P〉0.05）;右旋美托咪定组拔管后OAA/S评分低于对照组（P〈0.05）,躁动评分低于对照组P〈0.05）。结论全身麻醉中联合使用右旋美托咪定,不影响腹腔镜下子宫全切术患者的麻醉苏醒时间,使患者躁动等并发症减少,减低恢复室医护人员的护理风险。

Effect and Nursing Cooperation of Dexmedetomidine on Laparoscopic Hysterectomy Patients at the Recovery Period

Objective To determine the effect and nursing cooperation of dexmedetomidine on laparoscopic hysterectomy patients at the recovery period in general anesthesia. Methods 40 patients with laparoscopic hysterectomy were randomly divided into dexmedetomidine group（group D） or control group（group C）. At 30 minutes before induction of anesthesia, patients in group D were administered dexmedetomidine at a dose of 1 μg/kg over 10 min and in group C patients were given a placebo infusion of normal saline at identical rates.The two groups were given to endotracheal intubation, inhalation anesthesia. Patients in group D were administered dexmedetomidine at a dose of 0.3 μg·kg·h-1 in the maintenance of anesthesia and in group C patients were given a placebo infusion of normal saline. The extubation time and OAA/S score and agitation rate after extubation 15 min were recorded. Results OAA/S score and agitation rate in group D during periextubation were significantly different from those in group C （P 0.05）. Conclusion Dexmedetomidine can not affect the extubation time and effectively reduce the restlessness complications to extubation in patients with laparoscopic hysterectomy and nursing risk.