右美托咪定对上腹部手术后全麻苏醒期的影响

Effect of dexmedetomidine on the recovery period of general anesthesia after upper abdominal operation

目的观察右美托咪定对上腹部手术全麻苏醒期的影响。方法上腹部手术患者32例，随机均分为右美托咪定组（D组）和生理盐水组（C组）。术后均行硬膜外镇痛，D组给予右美托咪定0．05～0．1μg·kg^-1·h^-1，根据镇静评分调整输注速度，C组泵注等量生理盐水。记录入PACU5、30、60minMAP、HR、VAS评分、警觉／镇静评分（OAA／S评分）；记录术后6h内镇痛不全（VAS评分〉5分）及寒颤、呼吸抑制、恶心呕吐和皮肤瘙痒不良反应发生率。结果两组患者入PACU后5、30、60minMAP、HR差异无统计学意义。与C组比较，入PACU后60minD组VAS评分明显降低（P〈0．01），OAA／S评分差异无统计学意义。与C组比较，术后6hD组镇痛不全、寒颤、恶心呕吐发生率明显降低（P〈0．01），皮肤瘙痒差异无统计学意义。两组均未发生镇静过度和呼吸抑制。结论右美托咪定辅助用于上腹部手术术后，减少寒颤，增加耐受性；降低氧耗，减少苏醒期不良反应。

Objective To observe the effect of dexmedetomidine on the recovery period of gen- eral anesthesia after upper abdominal operation. Methods Thirty-two adult patients after upper ab- dominal operation were equally randomized into two groups. Group D received dexmedetomidine at the rate of 0.05-0. 1 μg·kg^-1·h^-1 , which was adjusted aceording to the sedation score, while group C received normal saline. Record VAS,PACU 5, 30, 60 min MAP,HR,OAA/S scale, Recrod the post- operative 6 h incomplete analgesia （VAS score〉5）,incidence of shivering, agitation, respiratory depression, and nausea and vomiting were compared between the two groups. Results Compared with group C, VAS was lower in group D at 60 min after the admission into PACU （P〈0.01）. The occurrence of incomplete analgesia, shivering, and nausea and vomiting were lower in group D than in group C （P〈0. 01）. No severe sedation and respiratory depression were found in the two groups. Conclusion Dexmedetomidine as an adjuvant drug can reduce the complications during the recovery period after upper abdominal operation.