全麻手术患者苏醒拔管期应用盐酸右美托咪定的价值

The Value of Dexmedetomidine Hydrochloride in Patients Undergoing General Anesthesia during Extubation

目的探讨全麻手术患者苏醒拔管期应用盐酸右美托咪定的价值。方法随机选取该院2018年1月—2020年10月收治的开颅手术患者50例为对象,所有患者围术期均行全身麻醉,根据患者苏醒拔管期是否使用盐酸右美托咪定分为观察组(n=25例)和对照组(n=25例)。两组术后均送至ICU,对照组手术结束前30 min静脉泵注等剂量生理盐水,观察组手术结束前30 min静脉泵注右美托咪定,术后3 d对患者效果进行评估,比较两组平均动脉压、心率、应激反应及并发症发生率。结果观察组T1、T2、T3时间点MAP水平(82.12±4.36)、(83.41±4.38)、(82.57±4.38)mmHg、HR水平(85.34±6.41)、(86.57±7.09)、(84.31±6.57)次/min低于对照组,差异有统计学意义(t=6.474、9.272、8.546、2.703、2.936、2.809,P<0.05);观察组术后3 d应激反应COR(155.93±16.31)ng/mL、E(20.41±4.09)pg/mL、NE(373.41±36.09)pg/mL及GlU水平(6.71±0.63)mmol/L低于对照组,差异有统计学意义(t=5.061、5.181、7.707、16.639,P<0.05);观察组苏醒拔管期躁动、呛咳、心律失常、呼吸抑制及恶心呕吐发生率8.00%低于对照组32.00%,差异有统计学意义(χ^(2)=4.500,P<0.05)。结论盐酸右美托咪定用于全麻复苏期患者拔除气管插管时有助于稳定其生命体征,降低拔管期应激反应,能降低躁动、呛咳等并发症发生率,值得推广应用。

Objective To explore the value of dexmedetomidine hydrochloride in patients undergoing general anesthesia during extubation.Methods 50 patients undergoing craniotomy in the hospital from January 2018 to October 2020 were randomly selected as subjects.All patients underwent general anesthesia during the perioperative period.According to whether the patients were treated with dexmedetomil hydrochloride during the extubation period.They were divided into observation group(n=25 cases)and control group(n=25 cases).Both groups were sent to the ICU after surgery.The control group was given the same dose of saline intravenously 30 minutes before the end of the operation.The observation group dexmedetomidine was given by the intravenous pump 30 minutes before the end of the operation.The mean arterial pressure,heart rate,stress response and the incidence of complications were compared between the two groups.Results The MAP levels(82.12±4.36)mmHg,(83.41±4.38)mmHg,(82.57±4.38)mmHg and HR levels(85.34±6.41)times/min,(86.57±7.09)times/min,(84.31±6.57)times/min of the observation group at T1,T2,T3 time points were lower than those of the control group,the difference was statistically significant(t=6.474,9.272,8.546,2.703,2.936,2.809,P<0.05);the observation group 3 d postoperative stress response COR(155.93±16.31)ng/mL,E(20.41±4.09)pg/mL,NE(373.41±36.09)pg/mL and GlU levels(6.71±0.63)mmol/L were lower than those of the control group,the difference was statistically significant(t=5.061,5.181,7.707,16.639,P<0.05);observation group of the occurrence of restlessness,choking,arrhythmia,respiratory depression and nausea and vomiting during the extubation period was 8.00%lower than that of the control group,32.00%,the difference was statistically significant(χ^(2)=4.500,P<0.05).Conclusion Dexmedetomidine hydrochloride can help stabilize the vital signs of patients with tracheal intubation during general anesthesia resuscitation,reduce the stress response during extubation,and reduce the incidence of restlessness,coughing and other complications.It is worthy of promotion application.