右美托咪定复合丙泊酚用于开胸手术患者麻醉的临床观察

Clinical observation of Anesthesia with Dexmedetomidine combined with Propofol in patient undergoing thoracic surgery

目的在开胸手术中，以丙泊酚为基础的全凭静脉麻醉，全程复合使用右美托咪定（DEX），探讨其对丙泊酚用量、血流动力学和睁眼时间等指标的影响。方法60例患者随机分为对照组（C组）和DEX组（D组），每组30例。D组于麻醉诱导前泵入DEX负荷剂量0．6μg／kg，继以0．2μg／（kg·h）持续泵注至手术结束前30min；C组以同样方式输注生理盐水。分别记录两组患者各时点平均动脉压，以及术中丙泊酚用量、睁眼时间和躁动评分等。：结果D组在T3～T6各时点MAP和HR变化幅度较c组小，差别具有显著性（P〈0．05），D患者组舒芬太尼和丙泊酚用量明显少于c组（P〈0．05），两组患者顺啊曲库铵用量和睁眼时间差异无统计学意义，D组躁动评分明显低于C组（P〈0．05）。结论DEX辅助全麻用于开胸手术患者，减少舒芬太尼和丙}白酚用量，血压更平稳，并降低苏醒期躁动的发生。

Objective To observe the effect of anesthesia with dexmedetomidine combined with propofol in patient under- going thoracic surgery. Methods Totally 60 selective thoracic surgery patients were randomly divided into control group （group C） and DEX group（ group D）,30 patients in each group. Patients in group D received intravenous injection of DEX（0. 6μg/kg） 15 min before induction,followed by a continuous infusion at a rate of 0. 2μg/（ kg· h） until 30 rain before the end of surgery. Group C received a volume-matched bolus and infusion of placebo（0. 9% saline）. HR and MAP were recorded before infusion drug（ TO ）, before induction （T1）, before intubation （T2）, after intubation（ T3 ）, at the time of open thoraces （ T4 ）, at the end of surgery （ T5 ） and after extubation （ T6 ）. The amount of sufentanil, cisatracurium and propofol consumed, eye-opening time, and restlessness during recovery were recorded. Results HR and MAP in group C at T3 - T6 were significantly increased compared with group D（ P 〈 0. 05 ）. The amount of sufentanil and propo- fol in group D is significantly decreased compared with group C. There was no significant difference in eye-opening time between two groups （P 〉 0. 05 ）. Compare with group C, restlessness score were significantly decreased in group D （P 〈 0. 05 ）. Conclusion DEX as an systemic anesthetic adjunct in thoracic surgery can reduce the amount of sufentanil and propofol consumed. The haemodynamic parameters were more stable. DEX can relieve restlessness during recovery.