右美托咪定用于阻塞型睡眠呼吸暂停低通气综合征经鼻气管插管全身麻醉的镇静效果

Sedative Effects of Dexmedetomidine in General Anesthesia for Obstructive Sleep Apnea Hypopnea Syndrome

目的探讨右美托咪定用于阻塞型睡眠呼吸暂停低通气综合征手术经鼻气管插管全身麻醉的镇静效果。方法选取2016年5月至2019年5月于沈阳医学院附属中心医院行手术治疗的阻塞型睡眠呼吸暂停低通气综合征患者68例作为研究对象,随机分为观察组和对照组,每组34例。对照组给予常规麻醉,观察组在对照组基础上加用右美托咪定。比较两组患者手术时间、苏醒情况,并记录术中丙泊酚用量、视觉模拟评分法(VAS)评分、Ramsay评分。结果两组患者手术时间比较差异无统计学意义(P>0.05),观察组呼吸恢复时间、呼之睁眼时间及拔管时间短于对照组,差异有统计学意义(P<0.05);观察组患者术中丙泊酚用量少于对照组,差异有统计学意义(P<0.05);VAS评分观察组术后1 h、4 h低于对照组,两组术后4 h高于术后1 h,差异有统计学意义(P<0.05);观察组术后1 h、4 h的Ramsay评分高于对照组,差异有统计学意义(P<0.05)。结论阻塞型睡眠呼吸暂停低通气综合征手术经鼻气管插管全身麻醉患者应用右美托咪定能有效减轻呼吸抑制,增强镇痛镇静效果。

Objective To investigate the sedative effects of dexmedetomidine on general anesthesia through obstructive sleep apnea hypopnea syndrome after nasal tracheal intubation in the operation. Methods A total of 68 patients with nasal tracheal intubation undergoing surgical treatment in Central Hospital Affiliated to Shenyang Medical College were randomly divided into an observation group and a control group, with 34 cases in each group. The control group was given conventional anesthesia, and the observation group was given dexmedetomidine on the basis of the control group. The operation time and awake condition were compared. Propofol dosage and the amount of anesthesia, visual analogue score(VAS) and Ramsay score in the operation were recorded. Results There was no significant difference in surgical time between the 2 groups of patients. The respiratory recovery time, eye opening time, and extubation time in the observation group were shorter than those in the control group, and the differences were significant(P<0.05);the dosage of pofenol in the observation group was less than the control group, and the difference was significant(P<0.05);the VAS score of the observation group was lower than that of the control group at 1 h and 4 h after operation, and the difference between the 2 groups at 4 h was higher than 1 h after operation. Ramsay score was higher than the control group at 1 h, 4 h after operation, and the difference was statistically significant(P<0.05). Conclusion Dexmedetomidine can effectively reduce respiratory depression, and enhance analgesic and sedative effects in patients of general anesthesia through obstructive sleep apnea hypopnea syndrome after nasal tracheal intubation in the operation.