右美托咪定对气管套管放置术后苏醒期躁动的影响

Effects of Dexmedetomidine on Emergence Agitation in Patients with Tracheal Cannula Placement

目的:观察右美托咪定对全麻下行气管套管放置术患者苏醒期躁动的影响。方法:全麻下行口腔癌根治和气管套管放置术患者54例随机分为对照组(C组)和右美托咪定组(D组)各27例,术毕前30 min C组输注生理盐水15 mL、D组输注含右美托咪定0.5 ug·kg^(-1)液15 mL。记录围术期生命体征;术后自主呼吸恢复时间、唤醒时间、恢复室停留时间及术后躁动发生情况。结果:两组间自主呼吸恢复时间、唤醒时间、恢复室停留时间差异无统计学意义;C组唤醒后1min HR、MAP明显高于基础值(P<0.01),而D组术毕时、唤醒即刻HR低于基础值,差异有统计学意义;D组苏醒期躁动发生率为22.2%,低于C组的51.9%(P<0.05),且躁动程度减轻(P<0.01)。结论:右美托咪定可减少全麻下行气管套管放置术患者苏醒期躁动的发生率、减轻躁动程度,同时不导致苏醒延迟。

Objective： To observe the effects of dexmedetomidine on emergence agitation in patients with tracheal cannula placement. Methods： 54 patients scheduled for radical oral cancer resection and tracheal eannula placement under general anesthesia were randomly divided into two groups： control group （group C,n =27）and dexmedetomidine group （group D, n=27）. Normal saline 15 mL or dexmedetomidine 0.5 ug.kg 1 diluted to 15 mL was administrated intravenously 30 mins before the end of surgery. Vital signs, respiration recovery time, awake time, time spent in the postanesthesia care unit, and emergence agitation after surgery were monitored. Results： There were no differences in the respiration recovery time, awake time, and time spent in the PACU between two groups（P〉 0.05）. Compared to baseline value, HR and MAP at 1 min after awake in group C were significantly higher （P〈 0.01）, HR at the end of surgery and the time of awake in group D were significantly lower（P〈0.01 or P〈0.05）. The incidence of agitation in group D was 22.2%, which was lower than that in group C （51.9%）（P〈0.05）. Similarly, the agitation degree in group D was lower than that in group C （P〈0.01）. Conclusion： Dexmedetomidine can effectively alleviate the incidence and degree of emergence agitation in the patients with tracheal cannula placement, without prolonging recovery time.