右美托咪定减轻七氟醚麻醉下整形手术患者术后躁动的效果

Efficacy of dexmedetomidine in attenuating postoperative agitation of patients after cosmetic surgery under sevoflurane anesthesia

目的观察右美托咪定减轻七氟醚麻醉患者术后躁动的效果。方法七氟醚吸入麻醉下行择期面部整形手术患者40例随机均分为两组:A组于全身麻醉诱导前10min内静脉泵注右美托咪定1μg/kg,其后持续输注右美托咪定0.3μg·kg^(-1)·h^(-1),直至手术结束前30min;B组不用右美托咪定作为对照。比较两组麻醉前后HR、MAP、RR和SpO2的变化和麻醉苏醒期躁动发生情况。结果 A组患者麻醉苏醒期HR慢于B组(P<0.05);两组MAP、RR和SpO2差异无统计学差异(P>0.05)。A、B组患者术后呼吸恢复时间、睁眼时间和拔管时间相仿(P>0.05)。A组患者麻醉苏醒期躁动发生率低于B组(10.0%vs.30.0%),且躁动程度也较重(P<0.05)。结论右美托咪定可明显降低七氟醚麻醉患者苏醒期躁动的发生,且不影响循环、呼吸功能稳定和苏醒拔管时间。

Objective To observe the efficacy of dexxnedetomidine in attenuating postoperative agitation of patients after cosmetic surgery under sevoflurane anesthesia. Methods Forty patients receiving elective facial plastic surgery were equally randomized into two groups. Group A was infused dexmedetomidine 1 μg/kg in 10 minutes before induction, which was followed by 0.3μg·kg^-1·h^-1infusion untill at 30 minutes before the end of operation. Group B did not use dexmedetomidine as the control. The HR, MAP, RR and SpO2 were monitored and the incidence of postoperative agitation was compared. Results During recovery from anesthesia, the HR was slower in group A than that in group B（P〈0. 05）, while the MAP, RR and SpO2 were not significantly different between two groups （P〉0. 05）. The times for the recovery of spontaneous breathing, eye opening and extubation were similar in two groups （P〉0. 05）. The incidence and severity of postoperative agitation was less in group A than that in group B （10. 0% vs. 30. 0%） （P〈0. 05）. Conclusion Dexmedetomidine can significantly reduce the incidence of agitation during recovery from sevoflurane anesthesia without adverse effects on the cardiopulmonery function and extubation.