右美托咪啶与芬太尼对七氟醚麻醉术后躁动的预防作用分析

Analysis of preventive effect of dexmedetomidine and fentanyl for agitation after sevoflurane anesthesia

目的:探讨右美托咪定与芬太尼对七氟醚麻醉术后躁动的预防作用。方法:收治实施外科手术并行七氟醚诱导和维持麻醉患者150例,随机分为3组,每组50例。A组患者在手术结束前10 min给予右美托咪定0.3μg/kg,B组患者给予芬太尼1μg/kg,C组患者给予0.9%氯化钠溶液。比较3组患者在给药后的呼吸循环变化情况以及躁动评分等,并观察不同组别患者的躁动发生率、苏醒时间以及离开麻醉后监测治疗室的时间。结果:不同时间点3组患者的呼吸循环状况的组间与组内比较差异均无统计学意义(P>0.05)。A、B、C 3组患者中,躁动的发生率分别为10.0%、16.0%和64.0%,A组和B组患者的躁动率显著低于C组,且A组低于B组,组间比较差异均有统计学意义(P<0.05)。苏醒时间的比较,A组、B组显著长于C组,组间比较差异均有统计学意义(P<0.05)。离开PACU的时间的比较,3组患者之间差异无统计学意义(P>0.05)。结论:右美托咪定和芬太尼均能有效降低七氟醚麻醉术后患者的躁动发生率,且与芬太尼相比,右美托咪定的效果更为显著,具有临床推广和应用价值。

Objective:To explore the preventive effect of dexmedetomidine and fentanyl for agitation after sevoflurane anesthesia.Methods:150 patients with surgical operation and anesthesia induced and maintained with sevoflurane were selected.They were randomly divided into three groups with 50 cases in each group.At 10 minutes before the end of the operation,A group was given dexmedetomidine 0.3 g/kg;B group was given fentanyl 1 g/kg;C group was given 0.9% sodium chloride solution.We compared respiratory and circulatory changes and restlessness scores after administration of the three groups,and observed the incidence of agitation,recovery time and leaving the PACU time of the three groups.Results:At different time points,compared with inter group and intra group of the three groups,there were no significant differences between the respiratory and circulatory conditions(P>0.05).In A,B,C group of patients,the incidence of restlessness was respectively 10%,16% and 64%,in the A group and B group,agitation rate were significantly lower than that of C group,and A group was lower than that in B group,there were significant differences between the groups(P<0.05).Compared the recovery time,A group and B group were significantly longer than that in C group,and there were significant differences between the groups(P<0.05).Compared the leaving PACU time,there was no significant difference between the three groups(P>0.05).Conclusion:Dexmedetomidine and fentanyl can effectively reduce the incidence of agitation after sevoflurane anesthesia,and compared with fentanyl,dexmedetomidine effect was more obvious.It was worthy of clinical promotion and application.