右美托咪定减轻阑尾切除术中牵拉反应的效果

Efficacy of dexmedetommidine in attenuating traction reaction during appendectomy

目的比较右美托咪定、咪达唑仑和氟-芬合剂对阑尾牵拉反应的抑制效果。方法阑尾切除术患者60例,采用椎管内麻醉。随机均分为三组,手术切皮前分别静脉注射右美托咪定1μg/kg(A组,输注10min)、咪达唑仑0.04mg/kg(B组)和氟芬合剂(C组,氟哌利多2.5mg^+芬太尼0.05mg)。A组术中输注右美托咪定0.5μg·kg^(-1)·h^(-1)维持。比较手术牵拉阑尾期的牵拉反应发生情况。记录HR、MAP和SpO2变化。结果三组患者手术前后HR、MAP和SpO2均较平稳,组间差异亦无统计学意义(P>0.05)。A组抑制术中阑尾牵拉反应的优良率高于B、C组(95.0%vs.65.0%、50.0%)(P<0.01)。结论右美托咪定减轻阑尾术中牵拉反应的效果优于咪达唑仑或氟-芬合剂。

Objective To compare the efficacy of dexmedetommidine ,midazolam and combined use of droperidol and fentanyl in attenuating traction reaction during appendectomy .Methods Sixty patients undergoing appendectomy under spinal anesthesia were equally randomized into three groups . Before surgical incision ,dexmedetomidine 1μg/kg was infused in 10 minutes in group A ,which was followed by dexmedetomidine 0.5μg ·kg^-1·h^-1） infusion during operation ,midazolam 0.04 mg/kg was injected in group B ,and droperidol 2.5 mg combined with fentanyl 0.05 mg was injected in group C . The severity of traction reaction during surgery was evaluated and compared among three groups .The changes of HR、MAP and SpO2 were recorded as well .Results HR ,MAP and SpO2 during operation were stable in three groups ,which were not significantly different among three groups（P〉0 .05） .The effectiveness rate of inhibiting traction reaction during surgery was significantly higher in group A than that in groups of B and C（95.0% vs .65.0% and 50.0% ）（P〈0 .01） .Conclusion Dexmedeto‐midine is better than midazolam or combined use of droperidol and fentanyl in inhibiting traction reaction during appendectomy .