摘要
目的评价右美托咪啶对肺叶切除术患者早期术后谵妄的影响.方法肺叶切除术患者70例,ASA分级Ⅰ或Ⅱ级,性别不限,年龄≤64岁,体重指数<30 kg/m2.采用随机数字表法,将患者随机分为2组(n=35),对照组(C组)和右美托咪啶组(D组).D组麻醉诱导前经15 min静脉注射右美托咪啶0.6μg/kg,随后以0.4μg/(kg.h)的速率静脉输注至术毕,C组给予等容量生理盐水.5 min后静脉注射舒芬太尼0.4μg/kg、依托咪酯0.2～0.3 mg/kg、顺阿曲库铵0.15 mg/kg麻醉诱导,气管插管后行机械通气.靶控吸入七氟醚呼气末靶浓度1%～3%、静脉输注舒芬太尼0.2μg/(kg.h)维持麻醉,术中维持BIS值40～55.术毕待拔除气管导管后送术后监护病房.采用ICU谵妄评估方法 (CAM-ICU)对患者进行谵妄评测.记录术后6 h内谵妄的发生情况.结果患者术后6h内谵妄发生率C组为31.4%,D组为5.7%,差异有统计学意义(P<0.05).结论右美托咪啶可降低肺叶切除患者早期术后谵妄的发生.
Objective To investigate the effect of dexmedetomidine on early postoperative delirium in patients undergoing pneumonectomy.Methods Seventy ASA ⅠorⅡ patients,aged ≤64 yr with a body mass index of 30 kg/m2,scheduled for elective pneumonectomy under general anesthesia,were randomly divided into 2 groups（n =35）：control group（group C）and dexmedetomidine group（group D）.Dexmedetomidine 0.6 μg/kg was infused intravenously over 15 min before anesthesia induction in group D and was maintained 0.4 μg/（kg.h）until operation end,while the same volume of normal saline was infused in group C.Anesthesia was induced by iv injection of sufentanil 0.4 μg/kg and etomidate 0.2～0.3 mg/kg until loss of consciousness.Tracheal intubation was facilitated with 0.15 mg/kg cisatracurium besylate and the patients were mechanically ventilated.Anesthesia was maintained with sevoflurane by target controlled inhalation（TCI）（end-tidal concentration set at 1%～3%） and sufentanil 0.2 μg/（kg.h）in both groups.BIS was maintained at 40～55 during operation.Patients were sent to Intensive Care Unit when operation end.All the patients were assessed for the development of delirium by experience research staff using Confusion Assessment Method for Intensive Care Unit.the incidence of postoperative delirium within 6 h after operation were recorded,and compared between the two groups.Results The incidence of postoperative delirium was significantly lower in group D than in group C（5.7% vs 31.4%）,P0.05.Conclusion Dexmedetomidine can reduce the occurrence of early postoperative delirium in patients undergoing pneumonectomy.
出处
《昆明医科大学学报》
CAS
2012年第9期88-91,共4页
Journal of Kunming Medical University
基金
云南省应用基础研究面上自筹项目(2010ZC179)
关键词
右美托咪啶
谵妄
手术后并发症
Dexmedetomidine
Delirium
Postoperative complication
