预注右旋美托咪啶用于喉显微手术麻醉的临床分析

Clinical analysis of the priming handed dexmedetomidine for laryngomicrosurgery anesthesia

目的分析在喉显微手术麻醉的患者中使用右旋美托嘧啶的效果。方法选取90例喉显微手术患者作为研究对象,并将其随机分成45例对照组与45例观察组;两组患者均在麻醉过程中使用右旋美托嘧啶、脂肪乳安慰剂、琥珀胆碱以及丙泊酚、雷米芬太尼;其中,对照组雷米芬太尼用量为1μg/kg,观察组雷米芬太尼用量为0.5μg/kg;分别记录两组患者T0(麻醉诱导前)、T1(插管时)、T2(喉镜置入时)、T3(拔管1 min)、T4(拔管5 min)的MAP(血动力学指标)、HR(血动力学指标)、NE(血浆去甲肾上腺素)以及E(肾上腺素)指标、麻醉恢复相关指标以及术后不良反应率。结果观察组患者的血流动力学指标在T0、T1、T2状态下与对照组相应指标差异无统计学意义;在T0、T3、T4状态均明显低于对照组(P<0.05)。观察组患者丙泊酚用量明显少于对照组(P<0.05)。观察组患者与对照组患者的各阶段麻醉恢复时间差异无统计学意义。观察组不良反应率明显低于对照组(P<0.05)。结论预注右旋美托嘧啶用于喉显微手术麻醉有助于降低患者的应激反应,对减少丙泊酚用量以及加强其镇静深度具有促进作用,且不良反应率低,安全性高,可推广。

Objective Analysis using Dexmedetomidine effects in patients with laryngeal microsurgery anesthetized. Methods To select 90 cas- es of laryngeal microsurgery patients as research subjects, And randomly divided into 45 cases in the control group and 45 cases in the observation group; Both groups use during anesthesia Dexmedetomidine, a placebo fat emulsion, succinylcholine and propofoll remifentanil;Among them, the control group in an amount of remifentanil 1 ~tg/kg, the observation group remifentanil dosage of 0.5 ~tg/kg;Two groups of patients were recorded T~, （before induction of anesthesia）, T~ （intubation）, T2 （when laryngoscope placement）, T3 （extubation 1 min）, T4 （extubation 5 rain） of MAP （hemody- namic indices）, HR （hemodynamic indices）, NE （norepinephrine） and E （adrenaline） indicators related indicators anesthesia and postoperative recov- ery rate of adverse reactions. Results Hemodynamic parameters observed in patients at To, T,, T2 state corresponding to the control group showed no significant differences; In To, T3, T4 status were significantly lower than the control group （P〈0.05）.The observation group were significantly less than the amount of propofol control group （P〈0.05）.The various stages of the observation group and the control group of patients with anesthesia re- covery time no significant difference. Adverse reactions observed group was significantly lower than the control group （P〈0.05）. Conclusion Dex- trose dexmedetomidine for laryngeal microsurgery anesthesia helps reduce the stress response in patients, Priming handed dexmedetomidine reduc- ing propofol sedation as well as to strengthen its role in promoting having, And the adverse reaction rate, high security, can be extended.