右美托咪定对神经外科全麻术后躁动发生影响分析

Analysis on the Impact of Dexmedetomidine for Patients Undergoing Neurosurgery General Anesthesia on Postoperative Agitation

目的:探讨右美托咪定用于神经外科全麻术患者对术后躁动发生的影响。方法:选取2011年7月-2012年8月在本院神经外科择期行全麻手术患者110例,随机分为右美托咪定组和生理盐水组,手术结束前10 min,右美托咪定组采用右美托咪定静脉泵注,生理盐水组采用等量生理盐水静脉泵注。记录两组患者唤醒时间、呼吸恢复时间和拔管时间,对两组患者拔管后躁动发生情况、躁动程度、镇痛和镇静状况进行评估。结果:两组术后唤醒时间、呼吸恢复时间和拔管时间比较差异均无统计学意义(P>0.05)。右美托咪定组麻醉拔管期躁动程度(0级、1级)和躁动发生率均低于生理盐水组,两组比较差异均有统计学意义(P<0.05)。右美托咪定组Ramsay镇静评分拔管后5 min、30 min均高于生理盐水组,两组比较差异均有统计学意义(P<0.05)。VAS疼痛评分拔管后5、30、60和120 min均显著低于生理盐水组,两组比较差异均有统计学意义(P<0.05)。结论:右美托咪定可以有效减少神经外科全麻术后躁动发生率和躁动程度,改善术后疼痛镇静效果,且不延长唤醒时间、呼吸恢复时间和拔管时间。

Objective：To investigate the impact of dexmedetomidine for patients undergoing neurosurgery general anesthesia on postoperative agitation. Method：One hundred and ten cases for elective anesthesia in the hospital neurosurgery were selected from July 2011 to August 2012. All cases were randomly divided into dexmedetomidine group and saline group. Before the end of surgery 10 min,cases in dexmedetomidine group were given dexmedetomidine intravenous infusion,and in saline group were given saline intravenous infusion. The wake-up time,breathing recovery time and extubation time of the two groups were recorded. After extubation,the occurrence of agitation,agitation degree,analgesia and sedation of the two groups were evaluated. Result：The differences of postoperative wake-up time,breathing recovery time and extubation time between the two groups were not significant（P〉0.05）. The agitation degree（0,1 grade）and agitation occurrence rate in anesthesia extubation in dexmedetomidine group were lower than those of the saline group,the differences were statistically significant（P〈0.05）. The ramsay sedation scores of dexmedetomidine group after extubation 5 min,30 min were higher than those of the saline group（P〈0.05）. The VAS pain scores after extubation 5 min,30 min,60 min and 120 min were significantly lower than those of the saline group,the differences all were statistically significant（P〈0.05）. Conclusion：Dexmedetomidine could reduce agitation occurrence rate and agitation degree of patients undergoing neurosurgery general anesthesia,and improve postoperative pain sedative effect. But it does not extend the wake-up time,breathing recovery time and extubation time.