右美托咪定预防妇科腹腔镜全身麻醉苏醒期躁动及对认知功能的影响

Dexmedetomidine Prevention of Restlessness in Recovery Period of General Anesthesia for Laparoscopy and Its Effect on Cognitive Function

目的探讨右美托咪定预防妇科腹腔镜患者全身麻醉苏醒期躁动及对认知功能的影响。方法选择2014年1月至2015年3月大连市妇女儿童医疗中心收治的行妇科腹腔镜手术的女性患者80例作为研究对象,依据抽签法随机分为试验组和对照组,各40例。对照组患者给予常规的麻醉,试验组患者在此基础上于手术结束前30 min静脉泵注0.5μg/kg右美托咪定,15 min内完成。比较两组患者麻醉苏醒期间的镇静评分、躁动评分、寒战评分、不良反应及认知功能。结果试验组镇静评分、躁动评分、寒战评分均高于对照组[(3.73±0.13)分比(1.48±0.10)分,(92.1±2.3)分比(79.6±2.4)分,(93.2±2.4)分比(79.8±1.3)分],差异有统计学意义(P<0.01)。术后,试验组简易精神状态评价量表评分低于对照组[(25.4±1.0)分比(27.5±0.7)分],差异有统计学意义(P<0.01)。试验组总不良反应发生率低于照组[7.5%(3/40)比35.0%(14/40)],差异有统计学意义(P<0.05)。结论右美托咪定预防妇科腹腔镜患者全身麻醉苏醒期躁动及寒战具有显著的临床效果,对认知功能影响小,值得推广。

Objective To explore dexmedetomidine prevention Of restlessness in recovery periad of general anesthesia for gynecological laparescopy restlessness and its effect on cognitive function. Methods Total of 80 female patients admired to Women and Children Health Care Center of Dalian from Jan. 2014 to Mar. 2015 were selected as the research objects, all the patients were randomly assigned to the trial group and the control group according to lottery method,40 patients each. The control group was treated with routine anesthesia treatment, while the trial group was given daxmedetomidine by 0. 5 μg/kg haft an hour before the end of surgery, administered within 15 min. The anesthesia sedation score, agitation： score, chills score, adverse reactions and cognitive function during anesthesia recovery of the two groups were compared. Results Sedation score,restlessness score, chills score of the trial group were higher than the control group[ （3.73± 0. 13） scores vs （1.48 ±0. 10） scores,（92. 1 ±2.3） scores vs （79.6 ±2.4） scores,（93.2 ±2.4） scores vs （79. 8 ± 1.3 ） scores ], the differences were statistically significant （ P 〈 0. 01 ）. After surgery, the Mini- Mental State Evaluation Scale scores of the trial group was lower than the control group [ （25.4 ± 1. 0） scores vs （27. 5 ±0. 7） scores] ,the difference was statistieally significant （P 〈0. 01 ）. Thetotal incidence of adverse reactions of the trial group was＇lower than the control group[ 7.5% （3/40） vs 35.0% （14/40） ], the difference was statistically significant （P 〈 0. 05 ）. Conclusion Dexraadetomidine prevention of restlesshess and chills during recovery period of general anesthesia for gynecological laparoseopy has a significant clinical effect,with little effect on cognitive function,thus is worthy of promotion.