持续静脉注射不同剂量右美托咪啶对甲状腺手术患者全麻恢复期的影响

Effect of continuous intravenous injection of different doses of dexmedetomidine on the recovery period of general anesthesia in patients undergoing thyroid surgery

目的分析持续静脉注射不同剂量右美托咪啶对甲状腺手术患者全麻恢复期的影响。方法选取陆军军医大学第一附属医院2017年11月至2019年11月收治的120例甲状腺手术患者,随机平均分为对照组60例持续静脉注射0.8μg/kg右美托咪啶,观察组60例给予0.4μg/kg。对比两组不同时间段SBP、DBP、HR、Ramsay、VAS评分、苏醒指标和不良反应发生情况。结果观察组不同时间段SBP、DBP、HR、VAS评分恶心、呕吐、喉痉挛,呛咳发生率与对照组差异无统计学意义。观察组不同时间段Ramsay评分均显著低于对照组(P<0.05)。观察组睁眼时间、拔管时间、定向力恢复时间均显著短于对照组(P<0.05)。观察组心动过缓发生率为1.67%显著低于对照组6.68%(P<0.05)。结论0.4、0.8μg/kg右美托咪啶应用于甲状腺手术患者全麻恢复期,均可维持血流动力学稳定,但0.8μg/kg镇静作用更明显,心动过缓发生率更高,故推荐使用0.4μg/kg右美托咪啶。

Objective To analyze the effect of continuous intravenous injection of different doses on dexmedetomidine on the recovery period of general anesthesia in patients undergoing thyroid surgery.Methods A total of 120 patients with thyroidectomy admitted to the First Affiliated Hospital of Army Medical University from November 2017 to November 2019 were randomly divided into a control group(60 patients)with continuous intravenous injection of 0.8μg/kg dexmedetomidine.The observation group(60 patients)were given 0.4μg/kg dexmedetomidine.The SBP,DBP,HR,Ramsay,VAS score,arousal index and adverse reactions were compared between the two groups at different time periods.Results The scores of SBP,DBP,HR and VAS,the incidence of nausea,vomiting,laryngospasm and choking cough in the observation group were not different from those in the control group at different time periods.The Ramsay scores of the observation group at different time periods were significantly lower than those of the control group(P<0.05).The time of eye opening,extubation and directionalforce recovery in the observation group were significantly shorter than those in the control group(P<0.05).The incidence of bradycardia in the observation group was 1.67%,which was significantly lower than that in the control group(6.68%)(P<0.05).Conclusions 0.4 and 0.8μg/kg dexmedetomidine can maintain hemodynamic stability in the recovery period of general anesthesia in patients undergoing thyroid surgery,but 0.8μg/kg has more sedative effect and higher incidence of bradycardia,so it is recommended to use 0.4μg/kg dexmedetomidine.