右美托咪啶对鼻内镜手术患者气管拔管期应激反应的影响

目的探讨右美托咪啶对鼻内镜手术患者气管拔管期应激反应的影响。方法选择ASAI～II级择期鼻内镜手术患者60例，随机分为右美托咪啶组（D组）和对照组（G组），各30例。D组在麻醉诱导后给予右美托咪啶0．5μg／kg泵注，于10min输注完毕。C组泵注15mL生理盐水。记录两组诱导前（T1）、注药后10min（T2）、苏醒时（T3）、拔管即刻（T4）、拔管后5min（T5）各时点的MAP及HR变化情况，记录苏醒时间、拔管时间及苏醒期躁动发生率。结果D组围拔管期的MAF、HR显著低于G组，差异有统计学意义（P〈0．05）。D组的苏醒期躁动发生率低于对照组（P〈0．05）。两组苏醒时间及拔管时间比较，无统计学意义（P〉005）。结论在鼻内镜手术患者中应用右美托咪啶，减少围拔管期心血管反应及苏醒期躁动的发生率，而不延长苏醒及拔管时间。

Objective To observe the effects of Dexmedetomidine on extubation response in patients undergoing endoscopic nasal surgery. Methods Sixty ASA I -rl patients undergoing nasal endoscopic surgery were enrolled in this study, patients were randomly divided into Dexmedetomidine group （group D） and control group （group C）.After induction, patients in Group D were subject to intravenous infusion Dexmedetomidine 0.5 ug/kg diluted to 15 mL via micropumps in 15 minutes, and group C received 15 mL normal saline infusion.Mean arterial pressure（MAP） and heart rate（HR） were recorded before induction （T ~）, 10 minutes after the injection （T 2）, recovery time （T 3）, extubation （T 4）, 5 min after extubation （Ts）.The recovery time and extubation time were recorded. Emergence agitation Was observed. Results During peri- extubation period, MAP and HR in Group D were significantly lower than that in Group C. The time to awkening and tracheal extubation were in different between the two groups.Less agitation was observed in Group D than Group C. Conclusion In patients undergoing endoscopic nasal surgery, Dexmedetomidine can effectively reduce cardiovascular response during extubation and the incidence of emergence agitation, but does not prolong the recovery and extubation time.