帕瑞昔布钠联合右美托咪定对神经外科全麻患者麻醉恢复期的影响

THE INFLUENCE OF PARECOXIB SODIUM COMBINED WITH DEXMEDETOMIDINE ON ANESTHESIA RECOVERY IN NEUROSURGERY PATIENTS UNDER GENERAL ANESTHESIA

目的观察帕瑞昔布钠联合右美托咪定对神经外科全麻患者麻醉恢复期的影响.方法：选择河北省衡水市哈励逊国际 和平医院于2014年1？12月收治需行神经外科手术患者80例作为研究对象, 按照配对分组法分为4组 , 每组20例 ,即帕瑞昔 布钠＋右美托咪定组（PD 组） 、 帕瑞昔布钠组（P 组） 、 右美托咪定组（D 组）和对照组（N 组） , 比较4组患者苏醒时间、 拔管时间、 恢复期不同时刻血流动力学相关指标、躁动发生率及恢复期镇静情况.结果：组患者苏醒时间及拔管时间比较,差异均无统计学意义（均 P 〉0.05）.诱导前（T0）组患者心跳（HR ）和平均动脉压（MAP ）比较差异均无统计学意义（均 P 〉0.05） , 拔管 前1 min （T1）、 拔管后1 min （T2）、 拔管后5 min （T3）、 拔管后10min （T4）时间点D 组和PD 组的 HR和MAP均明显低于N 组 （均P 〈0. 05）, 且 PD 组患者躁动及镇静情况均显著优于其他3组（均 P 〈 0 . 05）.结论：帕瑞昔布钠联合右美托咪定用于神经外科全麻患者可提供适度的镇静作用,患者躁动发生率低,且麻醉恢复期血流动力学更为稳定,具有重要的临床应用价值.

Objective： To observe the effect of parecoxib sodium combined with dexmedetomidine in anesthe-sia recovery in neurosurgery patients under general anesthesia. Methods： From January to December 2014, 80 neurosurgery patients were recruited and randomly divided into 4 groups： the parecoxib sodium plus dexmedetomidine group （PD group）,the parecoxib sodium group （P group）,the dexmedetomidine group （D group） and the control group （N group）,each with 20 cases. The recovery time,the extubatthe incidence of agitation, Ramesay sedation score and the hemodynamics at the respiration （T0 ）, 1 min before extubation （T1 ）, 1 min after extubation （T2 ） , 5 min after extubation （T3）,and 10 min after extubation （T4） were recorded and compared. Results： There were no significant differences among the four groups in the recovery time,the extubation time,heart rate（HR） and mean a - terial pressure （MAP） （ P 〉0. 05）. From T1 to T 4 ,HR and MAP in the D group and PD group were sig-nificantly lower than those in the N group （ P 〈 0 . 05）. The agitation incidence in lowest,and the sedation score was the highest among four groups （ P 〈0. 05）. Conclusion： Parecoxib so-dium combined with dexmedetomidine could enhance sedative effect, reduce agitation occurrence, and sta-bilize hemodynamics on anesthesia recovery period in patients undergoing neurosurgery general anesthesia, which has a significant clinical value.