右美托咪定预防全麻苏醒期躁动的临床观察

The clinical observation of dexmedetomidine for preventing agitation in anesthesia recovery period

目的:观察右美托咪定(dexmedetomidine,Dex)预防全麻苏醒期躁动的效果及安全性。方法:选择全麻手术患者60例,ASAⅠ～Ⅱ级,随机均分为Dex组(D组)与芬太尼组(F组)。D组手术前10 min开始用微量泵泵入Dex直至手术缝皮时停药,F组在手术缝皮时静脉注射芬太尼1μg/kg。观察2组患者自主呼吸恢复时间、拔除气管导管时间、麻醉苏醒期躁动的发生率及程度,并记录患者苏醒期恶心、呕吐、嗜睡以及呼吸抑制等不良反应的发生率。结果:2组患者自主呼吸恢复时间和气管导管拔除时间差异均无统计学意义(P>0.05);D组躁动的发生率及程度明显低于F组(P<0.01);恶心、呕吐、嗜睡和呼吸抑制的发生也显著少于F组(P<0.01)。结论:Dex可以减少全麻苏醒期躁动的发生率且没有呼吸抑制,用于预防全麻苏醒期躁动安全有效。

Objective：To observe the effect and safety of dexmedetomidine（Dex） for preventing agitation in anesthesia recovery period.Methods：Sixty patients（ASA Ⅰor Ⅱ） were randomly divided into two groups（n=30）.In Dex group（group D）,Dex was injected by micro pump 10 minutes before surgery and continued until wound was sutured.In fentanyl group（group F）,1 μg/kg fentanyl was injected when the wound was sutured.The spontaneous breathing recovery time,extubation time,the incidence and degree of anesthesia recovery period in all patients were observed.The recovery period with nausea and vomiting,drowsiness and respiratory depression and other adverse events were recorded.Results：There were no statistical differences about spontaneous breathing recovery time and extubation time in all patients of the two groups（P〉0.05）.Compared with group F,the incidence and degree of agitation in group D were significantly lower（P〈0.01）.Nausea,vomiting,drowsiness and respiratory depression were also significantly reduced（P〈0.01）.Conclusions：Dex applied in general anesthesia can reduce the agitation of anesthesia recovery period and no respiratory depression.It is safe and effective for preventing agitation in anesthesia recovery period.