右美托咪定对全麻麻醉深度和术后咽喉痛的影响

Effects of dexmedetomidine on depth of anesthesia and sore throat after general anesthesia

目的:探讨右美托咪定对麻醉深度及对全麻术后咽喉痛的影响。方法:选择择期行甲状腺肿瘤切除术患者40例,随机分为右美托咪定组和对照组,每组20例;在全麻下手术开始后10 min,右美托咪定组给予右美托咪定0.6μg/kg泵注10 min,继以0.2μg·kg-1·h-1维持泵注;对照组以相同方式输注生理盐水。监测并记录两组患者用药前即刻(T0)、用药后5 min(T1)、10 min(T2)、15 min(T3)、20 min(T4)、25 min(T5)、30 min(T6)的Narcotrend指数(NTI)、平均动脉压(MAP)、心率。比较两组患者在麻醉恢复室拔管时间、苏醒时间、镇痛药总用量及术后24 h咽喉痛发生率。结果:与对照组相比,右美托咪定组心率在T1~T6时间点明显降低(P<0.05),NTI在T3~T6时间点明显降低(P<0.05),T1~T6时间点MAP差异无统计学意义(P>0.05);两组患者拔管时间及苏醒时间差异无统计学意义(P>0.05);右美托咪定组术中镇痛药总用量和术后24 h咽喉痛发生率明显低于对照组(P<0.05)。结论:全麻患者术中静脉输注小剂量右美托咪定可增加麻醉镇静深度,并可有效预防全麻术后咽喉痛的发生。

Objective:To explore the effects of dexmedetomidine on depth of anesthesia and sore throat after general anesthesia.Methods:Forty ASA Ⅰ/Ⅱ patients undergoing thyroidectomy operation were ran-domly assigned into two groups:dexmedetomidine group (n =20)and control group (n =20).Ten minutes after the start of the operation,under general anesthesia,patients in the dexmedetomidine group received intravenous injection of dexmedetomidine 0.6 μg/kg for 10 min and followed by 0.2 μg·kg -1 ·h -1 for maintenance.Saline was applied in the same way in the control group.Monitored and recorded the NTI, MAP,heart rate before(T0)and 5 min(T1),10 min(T2),15 min(T3),20 min(T4),25 min(T5)and 30 min(T6)after administration;In PACU the eye opening time,extubation time,the total amount of an-esthetic and rate of sore throat within postoperative 24 h in two groups were compared.Results:Compared with the control group,the dexmedetomidine group showed lower heart rate at T1 -T6 (P <0.05),and decreased NTI at T3 -T6(P <0.05),while the MAP showed no significant difference in two groups at T1-T6(P >0.05).In PACU the eye opening time and extubation time of two groups were no significant difference(P >0.05),however,the total amount of anesthetic and the incidences of sore throat in dexme-detomidine group were significantly lower than the control group(P <0.05).Conclusion:Combination of small-dose dexmedet-omidine in general anesthesia could deepen the depth of the sedation,and may effec-tively prevent from sore throat after general anesthesia.