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盐酸右美托咪定对老年患者全麻苏醒期拔管应激反应的影响
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| 篇名： | 盐酸右美托咪定对老年患者全麻苏醒期拔管应激反应的影响 |
| TITLE： | |
| 摘要： | 目的：观察盐酸右美托咪定对老年患者全麻苏醒期拔管应激反应的影响。方法：将80例在全麻状态下行腹部手术的老年患者按照随机数字表法分为观察组和对照组，各40例。两组患者在术前、术中均行常规麻醉处理；手术结束前10 min，观察组患者给予稀释至10 ml的盐酸右美托咪定0.5 μg/kg静脉泵注，对照组患者给予10 ml 0.9％氯化钠注射液。比较两组患者在麻醉诱导前（T0）、注射盐酸右美托咪定或0.9％氯化钠注射液即刻（T1）、拔管前即刻（T2）、拔管时（T3）、拔管后1 min（T4）、拔管后5 min（T5）、拔管后10 min（T6）7个时间点的心率（HR）、平均动脉压（MAP）、血氧饱和度（SaO2）水平，两组患者在T0、T2、T4、T5、T6 6个时间点的Ramsay镇静评分，以及两组患者的呛咳评分、躁动评分、苏醒时间（t1）和拔管时间（t2）。结果：与T0比较，两组患者在T4、T5、T6时的HR、MAP波动幅度明显降低并逐渐趋向平稳，且观察组患者在T1～T6时的HR、MAP均明显低于对照组，差异均有统计学意义（P＜0.05）；但各时间点SaO2的组内及组间比较，差异均无统计学意义（P＞0.05）。两组患者在T2、T4、T5、T6时的Ramsay镇静评分比较，差异均有统计学意义（P＜0.05）。观察组患者的呛咳评分、躁动评分明显低于对照组，t1、t2明显短于对照组，差异均有统计学意义（P＜0.05）。结论：盐酸右美托咪定可缓解老年患者全麻苏醒期的拔管应激反应，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To observe the effects of dexmedetomidine hydrochloride on extubation stress response in elderly patients during general anesthesia recovery period. METHODS： 80 patients underwent general anesthesia of abdominal surgery were randomly divided into observation group and control group， with 40 cases in each group. Both groups received routine anesthesia before surgery and during surgery. 10 min before the end of surgery， observation group was given intravenous pump of dexmedetomidine hydrochloride diluted to 10 ml 0.5 μg/kg， and control group was given constant volume of 10 ml 0.9％ Sodium chloride solution. HR， MAP and SaO2 levels of 2 groups were compared before the induction of anesthesia （T0）， at the moment of intravenous injection of dexmedetomidine hydrochloride or 0.9％ Sodium chloride solution （T1）， at the moment immediately before extubation （T2）， at the moment of extubation （T3）， 1 min after extubation （T4）， 5 min after extubation （T5） and 10 min after extubation （T6）. Ramsay sedation score of 2 groups were compared at T0， T2， T4， T5 and T6； cough score， restlessness score， awake time （t1） and extubation time （t2） were also compared between 2 groups. RESULTS： Compared with at T0， the fluctuation of HR and MAR in 2 groups decreased significantly and became stable gradually at T4， T5 and T6， and HR and MAP of observation group at T1-T6 were significartly lower than those of control group， with statistical significance（P＜0.05）； but there was no statistical significance in SaO2 （P＞0.05）. There was statistical significance in Ramsay sedation score between 2 groups at T2， T4， T5 and T6 （P＜0.05）. The cough score and restlessness score of observation group were significantly lower than those of control group， and t1 and t2 were significantly shorter than those of control group， with statistical significance （P＜0.05）. CONCLUSIONS： Dexmedetomidine hydrochloride can relieve extubation stress reaction in elderly patients during general anesthesia recovery period with good safety. |
| 期刊： | 2016年第27卷第20期 |
| 作者： | 赵伟新，刘静，宋慧钢，李保林，吕东东 |
| AUTHORS： | ZHAO Weixin，LIU Jing，SONG Huigang，LI Baolin，LYU Dongdong |
| 关键字： | 盐酸右美托咪定；老年患者；全麻苏醒期；拔管；应激反应 |
| KEYWORDS： | Dexmedetomidine hydrochloride； Elderly patients； General anesthesia recovery period； Extubation； Stress response |
| 阅读数： | 303 次 |
| 本月下载数： | 2 次 |
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