摘要
目的观察不同剂量右旋美托咪啶对老年患者苏醒期躁动及气管拔管反应的影响。方法选择择期上腹部手术老年患者80例,随机分为对照组,右旋美托咪啶干预D1、D2和D3组各20例。手术结束前5 min对照组静脉注射0.9%氯化钠注射液20 ml;D1、D2和D3组分别单次缓慢静脉注射右旋美托咪啶0.2μg/kg、0.3μg/kg、0.4μg/kg。结果对照组苏醒拔管期间平均动脉压、心率波动显著,D1、D2、D3组较平稳;四组躁动、呛咳发生率比较,差异有统计学意义(均P<0.05);D3组苏醒时间显著长于其他三组(均P<0.05)。结论单次静脉注射右旋美托咪啶0.3μg/kg可有效降低腹部手术老年患者麻醉苏醒期躁动发生率,减少气管拔管反应而不延长气管拔管时间。
Objective To observe the effects of different doses of dexmedetomidine on agitation and extubation reactions in emergence period after general anesthesia in elderly patients.Methods Eighty patients aged 65-95 years undergoing elective abdominal operation under general anesthesia were studied and divided into 4 groups,with 20 patients in each group.The control group received intravenous injection of 20 ml saline,and the other 3 groups were given intravenous injection of different doses of dexmedetomidine 0.2,0.3,0.4 μg/kg respectively.Results Compared with the dexmedetomidine-treating groups,the fluctuations of arterial blood pressure（MAP） and heart rate（HR） in the saline-treating group were more significant;the incidence rates of agitation and endotracheal-tube-associated cough showed significant differences among the 4 groups（P0.05 for all）.The group treated with dexmedetomidine of 0.4 μg/kg had longer emergence period than the other groups（P0.05）.Conclusion The incidence of agitation and extubation reactions can be reduced by injecting 0.3 μg/kg dexmedetomidine in emergence period after general anesthesia in elderly patients without prolonging extubation time.
关键词
老年患者
全身麻醉
苏醒期
右旋美托咪啶
躁动
气管拔管反应
血流动力学
elderly patients
general anesthesia
emergence period
dexmedetomidine
agitation
extubation reaction
hemodynamics
