右美托咪定对扁桃体摘除术麻醉苏醒期躁动的影响

Effects of dexmedetomidine on emergence agitation after tonsillectomy

目的评价右美托咪定对扁桃体摘除术患者麻醉苏醒期躁动的影响。方法择期扁桃体摘除术患者60例,年龄12～20岁,体重35～65kg,ASAⅠ或Ⅱ级,随机均分为两组。麻醉诱导后,右美托咪定组(D组)在10min内静脉泵注右美托咪定1.0μg/kg(用生理盐水稀释至50ml),然后以0.5μg·kg-1·h-1持续泵入至手术结束前20min。对照组(C组)以同样方式泵注生理盐水。术中吸入异氟醚和静注丙泊酚维持麻醉。记录吸痰拔管时镇静-躁动(SAS)评分及拔管后10min的Ramsay镇静评分及VAS评分。结果 D组阿托品使用次数明显多于C组(P<0.05)。拔管时D组SAS评分明显低于C组,而Ramsay评分明显高于C组(P<0.05)。结论右美托咪定可明显减少扁桃体摘除术患者麻醉苏醒期间躁动的发生。

Objective To observe the effects of dexmedetomidine on emergence agitation in patients after tonsillectomy. Methods Patients aged 12-20 years, weighing 35-65 kg, ASA status Ⅰ or Ⅱ, were equally randomized into two groups, dexmedetomidine group （group D） and control group （group C）. Dexmedetomidine was given with 1.0 μg/kg within 10 min following anesthesia induction in group D, then was continuously given at 0. 5 μg·kg^-1 ·h^-1 till 20 min before the end of surgery. The same volume of normal saline was given in group C. Times and amount of atropine and ephedrine were recorded. Sedation-agitation score （SAS）at tracheal extubationand ramsay score at 10 min after tracheal extubation were recored. Results Amount and times of atropine, Ramsay score were higher, SAS was lower in group D than in group C （P〈0. 05）. Conclusion Dexmedetomidine can reduce the occurrence of emergenc agitation in tonsillectomy.