右美托咪定对老年患者全麻苏醒期谵妄影响的观察

The Effect of Dexmedetomidine for Emergency Delirium in Elder Patients

目的：观察右美托咪定对老年患者苏醒期谵妄的影响。方法：选择行气管插管全麻患者120例,年龄60~80岁,ASAⅠ~Ⅱ级,分为对照组（P1组）、右美托咪定标准注射组（D1组）、右美托咪定持续泵注组（D2组）,每组40例。麻醉方法：麻醉常规诱导后对照组为生理盐水泵注,D1组为DEX0.8ug/kg·h泵注15min,随后根据患者体征变化在0.2~0.7ug/kg·h范围内泵注至总量50ug;D2组为DEX0.5ug/kg·h持续泵注,泵注总量同样为50ug。于术前一天和术后苏醒期进行简易智能检查状态评分（MMSE）以及谵妄（Delirium）评定。结果：三组老年患者苏醒期谵妄（Emergency Delirium,ED）发生率分别为27.5%、7.5%和15.0%。结论：右美托咪定应用于老年全麻患者,可减少苏醒期谵妄发生的风险。

Objective To observe the effect of Dexmedetomidine for Emergency Delirium in elder patients.Methods 120 ASAⅠ~Ⅱ patients aged 60~80ys under general anesthesia were enrolled in this study。The patients were randomly assigned to three study groups：Group P1 received received NS 50 m L IV,Group D1 received Dexmedetomidine pumping-in 0.8 ug/kg·h,D2 received Dexmedetomidine pumpingin 0.5 ug/kg·h continuouing.Anesthesia was induced maintained with inhaled sevofurane and intravenous propofol.The MMSE scores and delirium were observed for the preoperative and postoperative 2h. Results：The incidences of delirium were 27.5%,17.5%and 15.0%for elder patients among Group P1 and D1,D2.there are difference of statistics for the MMSE scores between the preoperative and postoperative.There are difference with the postoperative between P1 groups and D1 groups. There are difference with the postoperative between P1 groups and D2 groups.Conclusion ：Dexmedetomidine maybe can reduce the incidence of Delirium for elder patients.