右美托咪定在悬雍垂腭咽成形术后麻醉苏醒期的镇静效果观察

Sedative effect observation of dexmedetomidine in anesthesia recovery period after uvulopalatopharyngoplasty

目的观察悬雍垂腭咽成形术（UPPP）中右美托咪定对术后镇静效果。方法 2014年10月-2015年12月笔者所在医院阻塞性睡眠呼吸暂停综合征（OSAS）全麻下行UPPP的患者60例,将患者随机方式分为对照组（S组）和右美托咪定组（D组）,每组30例。D组静脉输注右美托咪定在手术结束前30min,0.5μg/kg为注射剂量,持续注射15min,S组输注生理盐水。记录各组血液动力学变化及术后躁动及疼痛程度。结果 D组拔管时、拔管后心率和平均动脉低于S组;D组中苏醒期躁动发生率显著低于S组;D组拔管后5min和术后24h VAS评分低于S组,吗啡使用人数也少于S组,差异均有统计学意义（P〈0.05）。结论应用右美托咪定在UPPP手术中可以维护患者麻醉苏醒期间血流动力学趋稳定,并明显减少苏醒期的躁动且镇痛效果良好。

Objective To observe the sedative effects of dexmedetomidine in anesthesia recovery period after uvulopalatopharyngoplasty. Methods 60 cases of patients with obstructive sleep apnea syndrome（OSAS） cured with UPPP under general anesthesia in Foshan Chancheng Huanan Ear-Nose-Throat Hospital from October 2014 to December 2015 were selected and randomly divided into control group（group S） and dexmedetomidine group（group D）, with 30 cases in each group. Dexmedetomidine were injected before 30 min the end of surgery in Group D, and the infusion of dose was 0.5μg/kg, the infusion of time were15 min, saline infusion were injected in group S. Hemodynamic changes, postoperative agitation and degree of pain of the two groups were monitored. Results Heart rate and mean arterial pressure at extubation after extubation of group D were lower than those in group S. Awakening period of agitation rate of group D was lower than that of group S. VAS scores of 5 min after extubation and 24 h postoperative in group D were less than those in group S. morphine use of group D was fewer than group S, and the difference was statistically significant（P〈0.05）. Conclusion Application dexmedetomidine in the UPPP patients can maintain anesthesia during waking hemodynamic stability, and it can reduce the awakening period of agitation. It has good sedative effects.