右美托咪定对开胸手术患者苏醒期躁动的影响

Using of dexmedetomidine for prevention of agitation in patients undergoing thoracotomy

目的探讨静脉输注右美托咪定对开胸手术患者麻醉苏醒期躁动的影响。方法选择ASA I或Ⅱ级择期行开胸手术的患者40例,分为右美托咪定组(A组)和生理盐水对照组(B组)。A组患者在麻醉诱导前给予右美托咪定负荷剂量0.8μg/kg(给药时间>10 min)及0.4μg/(kg.h)的维持量。B组以同等方法泵入生理盐水。术中采用多功能脑电监测仪(BIS),了解麻醉深度。观察患者苏醒期躁动情况。结果苏醒期各个时点A组心率、血压增高的程度均低于B组(P<0.05)。躁动例数A组较B组少(P<0.05)。结论右美托咪定可使全麻开胸手术患者苏醒期的血流动力学更稳定,躁动减少。

Objective To investigate the use of dexmedetomidine for prevention of agitation on patients undergoing thoracotomy. Methods Forty ASA Ⅰ-Ⅱ patients undergoing thoracotomy were enrolled in this study. The patients were randomly divided into two groups （Group A and Group B）. Group A： Just 10 min before general anesthesia induction, the patients were injected with dexmedetomedine at the rate of 0.8 μg/kg as a load dosage. Followed by the rate of 0.4 μg/（kg·h） as the maintenance dose after intubation. Group B： Normal saline was given at the same rate in the correspondingly periods of time. BIS was used for anesthesia depth monitoring during surgery. Emergence agitation was observed in the recovery time after general anesthesia. Results During recovery time, heart rate and blood pressure in group A were significantly lower than that in group B （P 〈 0.05）, and the number of patients who were diagnosed as agitation in group A was significantly smaller than that in group B （P 〈 0.05）. Conclusion Use of dexmedetomidine in patients undergoing thoracotomy makes hemodynamics more stable and less agitation during the recovery time after general anesthesia.