右美托咪定对全麻下行颅骨修补术患者术后苏醒影响.docVIP

右美托咪定对全麻下行颅骨修补术患者术后苏醒影响 　　【摘要】 目的：探讨右美托咪定对全麻下行颅骨缺损修补术患者术后苏醒的影响。方法：选取本院2008年2月-2013年11月收治的63例ASA分级Ⅰ～Ⅱ级行择期颅骨修补术的患者作为研究对象，将其随机分为D1组（右美托咪定用量为0.5 μg/kg）、D2组（右美托咪定用量为1.0 μg/kg）和C组（生理盐水对照组）。所有患者全麻诱导与维持方法相同。记录拔除气管导管时（T1）、拔除气管导管后5 min（T2）、10 min（T3）、30 min（T4）各个时点的躁动评分（RS）。记录手术时间、拔管时间（从给右美托咪定或生理盐水至拔除气管导管时间）、离室时间（从拔除气管导管至离开手术室的时间）和苏醒过程中的呛咳、恶心、呕吐和心血管不良事件发生情况。结果：三组患者的拔管时间、离室时间和手术时间比较差异均无统计学意义（P0.05）；T1、T2、T3、T4各时点，D1组和D2组的RS均明显低于C组，差异均有统计学意义（P0.05）。D1组和D2组的呛咳发生率均明显低于C组（P0.05），D1组的心血管不良事件发生率均明显低于D2组和C组，差异均有统计学意义（P0.05）。结论：缝皮时，静脉泵注右美托咪定0.5 μg/kg，提高了颅骨修补术患者术后苏醒质量，更为安全有效。 　　【关键词】 右美托咪定； 颅骨缺损； 全身麻醉； 恢复期 　　Effects of Dexmedetomidine on the Postoperative Recovery of Patients with Cranioplasty under General Anesthesia/XIAO Sheng-hua，TAN Su-yun，WANG Zhi-jun，et al.//Medical Innovation of China，2015，12（23）：055-057 　　【Abstract】 Objective：To investigate the effects of Dexmedetomidine on the postoperative recovery of patients with cranioplasty under general anesthesia.Method：Sixty-three ASA Ⅰ or Ⅱ patients with cranioplasty admitted to our hospital from February 2008 to November 2013 were selected as research objects，they were randomly divided into the group D1（Dexmedetomidine dosage was 0.5 g/kg），the group D2（Dexmedetomidine dosage was 1.0 g/kg） and the group C（the normal saline control group），21 cases in each group.The same induction and maintenance of general anesthesia were used in each group.At the time of suturing scalp，Dexmedetomidine 0.5 μg/kg and 1.0 μg/kg were infused by micropump within ten minutes in group D1 and group D2 respectively，while the equal volume of 0.9% normal saline was administered instead of Dexmedetomidine in group C.Restlessness scores（RS） were assessed and recorded at immediately（T1） and 5，10，30 minutes（T2，T3，T4 respectively） after extubation.The operation time，extubation time（from infusion of Dexmedetomidine or normal saline to tracheal extubation），the time of leaving the operating room（from tracheal extubation to leaving the operating room） were recorded.