右美托咪定对功能性鼻内窥镜手术患者苏醒期质量的影响?

【目的】研究术中输注右美托咪定对功能性鼻内窥镜手术(FESS)患者苏醒期质量的影响。【方法】选取40例年龄为30~60岁择期全身麻醉下行 FESS 的患者。将入选患者随机分为两组(每组20例)：对照组(C组)和右美托咪定组(D组)。常规麻醉诱导气管插管后,D组给予1μg/kg 右美托咪定10 min内静脉输注完毕,随后以0.2μg/(kg·h)速率输注至手术结束前30 min。C 组以同样方式输注等量生理盐水。两组麻醉维持均采用静脉持续输注异丙酚,七氟醚吸入,适时静注顺式阿曲库铵。当患者平均动脉压(MAP)和心率(HR)较基础值增加超过15%时单次追加芬太尼1.5μg/kg。比较两组患者麻醉前、手术结束时、拔管时、离开麻醉恢复室(PACU)时的 HR、MAP；入 PACU 后的 Riker 躁动评分、VAS 疼痛视觉模拟评分；拔管时间、滞留PACU时间以及术后不良反应情况。【结果】与麻醉前比较,C 组患者拔管时 HR 明显增快(P <0.05)。入PACU后D组 Riker躁动评分和 VAS疼痛视觉模拟评分均低于 C组(P <0.05)。两组拔管时间、滞留PACU时间的差异均无显著性(均P >0.05)。D组术后寒战发生率低于 C 组(P <0.05)。【结论】术中输注右美托咪定可明显改善 FESS患者苏醒期质量。

Effects of Dexmedetomidine Infusion on the Recovery Profiles in Patients Undergoing Function-al Endoscope Sinus Surgery

Obj ective]To investigate the effects of continuous infusion of dexmedetomidine on postopera-tive recovery after functional endoscope sinus surgery(FESS).Methods]Forty patients aged 30 to 60 years who were scheduled for FESS under general anesthesia were included in this study.Participants were randomly assigned to 2 groups (n=20 each):control group,group C;dexmedetomidine group,group D.Ten minutes after the induction of anesthesia dexmedetomidine in a dose of 1μg/kg over 10 min,a continuous infusion of 0.2μg/(kg·h)until 30 min before the end of surgery was conducted in group D.Group C received normal sa-line instead.Anesthesia was maintained with propofol and sevoflurane.Additional cisatracurium was added if necessary.Fentanyl 1.5μg/kg was given to subjects in both groups for an increase in HR or MAP 15% above pre-incision values.HR and MAP were recorded at the following time points:arriving at OR (operation room),the end of surgery,at tracheal extubation,and when discharging from PACU.Riker scores and VAS were assessed 10,20,30min after entrance into PACU.Time to extubation,discharge from PACU,and post-operative adverse events such as vomiting or shivering were also recorded.Results]Compared with baseline HR,HR increased by the time of tracheal extubation in group C.Riker scores and VAS were lower in group D (P <0.05).Times from extubation to discharge in PACU were similar between the two groups (P >0.05). The incidence of shivering was decreased in group D (P <0.05).Conclusion ]Intraoperative administration of dexmedetomidine seems to promote postoperative recovery in patients undergoing FESS.