右美托咪定对妇科腹腔镜手术患者全麻苏醒期的影响

Effects of dexmedetomidine on quality of emergence from general anesthesia in patients undergoing gynecologic videolaparoscopic operation

目的评价右美托咪定用于妇科腹腔镜手术患者全麻苏醒期的有效性和安全性。方法择期行妇科腹腔镜手术患者60例,ASAⅠ或Ⅱ级,采用随机数字表法,随机均分为:右美托咪定组(D组)和对照组(C组)。两组均采用全凭静脉麻醉,手术结束前30 min D组患者单次静脉泵注右美托咪定0.5μg/kg,10 min内注药完毕。C组以同样方式输注生理盐水。手术结束缝皮前停用静脉麻醉药,手控诱导呼吸。记录患者自主呼吸恢复时间、苏醒时间、拔管时间、Ramsay镇静评分及拔管时患者出现呛咳、躁动等全麻苏醒期不良反应的情况。结果两组呼吸恢复时间、苏醒时间、拔管时间差异均无统计学意义;D组Ramsay镇静评分明显高于C组(P<0.05)。D组呛咳、躁动发生率明显低于C组(P<0.05)。两组在拔管后均未发生呼吸抑制。结论妇科腹腔镜手术患者手术结束前30 min单次静脉泵注右美托咪定未发生呼吸抑制及气道不良反应,未延长拔管时间,提高了全麻苏醒期的质量。

Objective To evaluate the efficacy and safety of dexmedetomidine on the quality of emergence from general anesthesia in patients undergoing gynecologic videolaparoscopic operation.Methods Sixty ASA Ⅰ or Ⅱ patients undergoing gynecologic videolaparoscopic operation were equally randomized into two groups （n =30 each）：the dexmedetomidine group （group D） and the control group （group C）.Total intravenous anesthesia （TIVA） was used in the two groups.Dexmedetomidine at 0.5 μg/kg were infused over 10 min in the group D 30 min before the end of surgery,while saline was used in the group C.Intravenous anesthetics were stopped.The time for recovery of spontaneous breathing,emergence time,extubation time,Ramsay score,and adverse reactions were recorded.Results There was no significant difference in spontaneous breathing time,emergence time and extubation time between the two groups.Compared with the group C,the rates of agitation,bucking decreased and Ramsay score increased in the group D （P 〈 0.05）.There was no respiratory depression after extubation in the two groups.Conclusion There was no respiratory depression and airway incidence of adverse events after a single dose infusion of dexmedetomidine 0.5 μg/kg before the end of surgery,and the extubation time did not increase The quality of emergence from general anesthesia recovery was improved in the patients undergoing gynecologic videolaparoscopic operation.