右美托咪啶对依托咪酯瑞芬太尼全麻后 躁动影响.docVIP

右美托咪啶对依托咪酯-瑞芬太尼全麻后 躁动影响 　　【摘要】目的探讨手术结束前右美托咪啶的使用对依托咪酯-瑞芬太尼全麻后患者躁动的影响。方法100例择期全麻下妇科腹腔镜手术的患者, ASA I~II级, 随机分为右美托咪啶组(D组, 50例)和对照组(C组, 50例), 常规麻醉诱导：气管插管后控制呼吸。术中麻醉维持：依托咪酯靶控效应室(Arden Model)浓度为0.3 μg/ml, 瑞芬太尼0.20~0.4 μg/(kg?min)持续输注, 维库溴铵维持肌松。手术结束前30 min接静脉镇痛泵。两组患者均于手术结束前10 min停止麻醉药物的输入, 用静脉推注泵分别静脉推注生理盐水(C组)和右美托咪啶0.5 μg/kg, 推注时间均为10 min。比较两组的苏醒、拔管时间、拔管期间患者躁动的情况, 观察HR、SBP、DBP、RR的变化。结果镇静和躁动情况与T0比较, C组T2、T4、T5时镇静评分均降低(P　　【关键词】右美托咪啶；全麻苏醒期；气管拔管；镇静；躁动 　　 　　Effect of dexmedetomidine on agitation after etomidate-remifentanil general anesthesia WANG Zi-shen, WANG Fu-jun, KONG Min-min, et al. Department of Anesthesiology, Affiliated Hospital of Taishan Medical College, Taian 271000, China 　　【Abstract】Objective To investigate the effect of dexmedetomidine on agitation after etomidate-remifentanil anesthesiabefore end of surgery. Methods Chose 100 patients who under general anesthesia laparoscopic operation, ASA I~II, randomly divided them into dexmedetomidine group(group D, 50 cases) and control group(group C, 50 cases), routine anesthesia induction, after tracheal intubation, breath control, maintenance of anesthesia: etomidate target controlled effect compartment (Arden Model) concentration of 0.3 μg/ml, remifentanil 0.20~0.4 μg/(kg?min) continuous infusion, vecuronium to maintain muscle relaxation. Operation before the end of 30 min after intravenous analgesia pump. Two groups of patients in operation before the end of the 10min stop drug input, using intravenous injection pump intravenous injection of physiological saline (group C) and dexmedetomidine 0.5 μ g/kg, injection time of 10min. Compared with two groups of awakening, extubation time, extubation agitation of patients with HR, to observe the change of situation; SBP, DBP, RR. Analysis of data using SPSS 13 statistical softwar. Results Sedation and agitation conditions compared with T0 group, Ramsay score decreased at T2, T4, T5 in group C(P0.05)。 　　1. 2方法 　　1. 2. 1麻醉方法患者常规禁饮禁食, 均不用术前药。入室后常规监测SBP、 DBP 、HR 、ECG、SpO2及PETCO2,