盐酸右美托咪定在全身麻醉患者围拔管期的临床疗效

目的：观察盐酸右美托咪定用于全身麻醉患者围拔管期时临床效果和安全性。方法：选择全身麻醉术后患者90例，随即分成3组(n=30)：盐酸右美托咪定组(DEX组)、盐酸咪达唑仑组(MID组)、对照组(C组)。术前10 min停用所有麻醉药，同时DEX组首先给予负荷剂量盐酸右美托咪定1 μg/(kg.h)，静脉泵入10 min，继以0.3 μg/(kg.h)的速度持续泵入至术后20 min；MID组首先60 s内静脉给予盐酸咪达唑仑0.5 mg/kg，继以0.04 mg/(kg.h)的速度持续泵入至术后20 min；C组无干预措施。记录术后唤醒时间、拔管时间以及拔管时、拔管后10 min、拔管后1 h患者Ramsay评分、平均动脉压、心率、血氧饱和度及自主呼吸的情况；观察患者术后寒战、恶心、呕吐及不良反应情况。结果：DEX组不影响唤醒及拔管，MID组有苏醒延迟(P<0.05)；与C组相比，DEX组与MID组均可获得良好镇静，Ramsay评分控制在2~4分；DEX组与MID组的心率、血压平稳，而MID组对呼吸有明显抑制(P<0.05)；DEX组明显减少术后寒战、恶心、呕吐的发生。结论：盐酸右美托咪定应用于全身麻醉围拔管期，不影响唤醒及拔管时间，能够抑制异常的血压升高及心率增快，而且减少躁动、寒战、术后恶心呕吐的发生，从而改善麻醉后的复苏。

Clinical therapeutic effect of dexmedetomidine on patients during the extubation period of general anesthesia

Objective: To observe the clinical eff ect of dexmedetomidine on patients during the extubation ingeneral anesthesia.Methods: A total of 90 patients scheduled for general anesthesia were divided into 3 groups (n=30): A dexmedetomidine group (DEX group), a midazolam group (MID group), and a controlgroup(C group). Anesthesia drugs were stopped 10 minutes before the end of the operation. At the same time, the patients in the DEX group were given dexmedetomidine at the rate of 1 g/(kg.h) for 10 min by vein fi rst, which was continuously pumped at the rate of 0.3 g/(kg.h) for20 min aft er the operation. Th e patients in the MID group were given midazolamin at 0.5 mg/kg for60 s by vein first, which was continuously pumped at the rate of the 0.04 mg/(kg.h) for 20 min afterthe operation. The patients in the C group were not given any drug. Awakening time and extubationtime after the operation were recorded. Ramsay scores, heart rate, mean arterial blood pressure,respiratory rate, and SpO2 were recorded at time of extubation, 10 min or 1 h after extubation.Chills, nausea, vomiting and other side effects after the operation were recorded.Results: Awakening and extubation time were not affected in the DEX group, while delayedrecovery occurred in the MID group (P<0.05). Compared with the C group, patients in the DEXand MID groups gained better sedative effect, with 2–4 Ramsay scores (P<0.05). The bloodpressure and heart rate were steady in the DEX and MID groups, while inhibition of respirationappeared in the MID group.Conclusion: Dexmedetomidine can provide an effective sedation for the patients without affectingthe awakening and extubation time. The hemodynamics could be stably maintained by usingdexmedetomidine in patients during the extubation in general anesthesia.