右美托咪啶对结直肠癌手术麻醉后寒战的影响

Influence of Dexmedetomidine on Shivering after Anesthesia in Patients Undergone Colorectal Surgery

目的探讨右美托咪啶对结直肠癌手术患者麻醉后寒战的影响。方法 78例直肠恶性肿瘤患者随机分为观察组(39例)与对照组(39例),观察组于术中给予右美托咪啶、对照组给予曲马多治疗麻醉后寒战,比较两组的临床效果。结果两组患者手术时间及围手术期阿托品、麻黄碱及去氧肾上腺素使用率差异无统计学意义(P>0.05);观察组在气管插管后15min及气管插管拔除后收缩压(SBP)及心率(HR)均显著低于对照组(P<0.01),氟比洛芬酯使用率及VAS评分显著低于对照组(P<0.05);观察组寒战发生率为15.4%,显著低于对照组的53.8%(P<0.01),寒战分级显著低于对照组(P<0.01),寒战持续时间显著短于对照组(P<0.01);观察组不良反应发生率显著低于对照组(P<0.05)。结论右美托咪啶在结直肠癌手术患者中具有良好的控制麻醉后寒战的效果,且对血流动力学的影响较小,安全可靠,值得推广。

Objective To explore the clinical effects of dexmedetomidine on shivering after anesthesia in patients undergoing colorectal surgery. Methods Seventy-eight patients undergoing colorectal surgery were randomly divided into the observation group （ N = 39） and the control group （N = 891. The observation group were given dexmedetomidine, and the control group were given tramadol to treat the shivering after anesthesia. The clinical effects were compared between the two groups. Results There was no significant difference in operation time, utilization of Atropine, ephedrine, and phenylephrine between the two groups （P 〉0.05） ; The SBP and HR of 15min after intubation and after removal of endotracheal intubation were significantly lower in the observation group than those of the control group （ P〈0.01 ）. Utilization of Flurbiprofen and VAS in the observation group were significantly lower than the control group （ P 〈 0.05 ） ; In the observation group, the incidence of shivering after anesthesia was 15.4%, which was significantly lower than 53.8% in the control group （ P 〈0.01）. The shivering classification, the shivering duration and the incidence of adverse reaction in the observation group was significantly superior to those in the control group （P 〈0.05）. Conclusion Dexmedetomidine has good clinical effects on shivering after anesthesia in patients undergoing colorectal surgery, and it has less impact on hemodynamics, which is safe and reliable, worthy of promotion.