右旋美托咪啶预防颅脑肿瘤切除术患者恢复期拔管应激反应及护理

Role of Dexmedetomidine in the Prevention of Stress Reaction for Extubation in the Recovery Period After Craniotomy

目的观察应用右旋美托咪啶(DEX)对全身麻醉下脑部肿瘤切除术患者恢复期拔管应激反应的预防作用及其护理。方法选择择期行脑部肿瘤切除术患者40例,随机分为两组,D组(n=20)术中静脉输注右旋美托咪啶0.5μg·kg-1·h-1,C组(n=20)输注等容量生理盐水安慰剂。记录患者麻醉前、拔管即刻、拔管后15 min的血流动力学指标、呼吸恢复时间、苏醒时间、拔管时间和镇静-躁动评分(SAS)。结果两组患者的手术时间与拔管时间差异无统计意义(P>0.05),HR和MAP在拔管即刻低于C组(P<0.05),术后SAS评分增高、躁动发生率降低(P<0.05)。结论右旋美托咪啶可有效预防颅脑肿瘤手术患者全麻恢复期的拔管应激反应,减轻恢复期护理工作量。

Objective To investigate the effect of dexmedetomidine in reducing stress reaction during recovery on patients receiving craniotomy after general anesthesia.Methods 40 patients receiving craniotomy for cerebral tumors were randomly divided into group D（administration 0.5 μg·kg-1·h-1of dexmedetomidine by intravenous infusion during the operation） and group C（administration normal saline）.The hemodynamic parameters,the time of breathing recovery,revival,extubation and the SAS scores were recorded.Results There was no statistical difference in the operation time and extubation time between the two groups（P 0.05）.Compared with group C,HR and MAP decreased significantly at the time of extubation in group D（P 0.05）,and the SAS sedation score,accident rate of agitation also significantly decreased in group D（P 0.05）.Conclusions Dexmedetomidine is effective in reducing stress reaction for extubation during recovery after general anesthesia in patients receiving craniotomy.As a result,nursing care is simplified.