【摘要】 目的:研究右美托咪定对阿片类成瘾患者在全麻下超快速脱毒中的效果。方法:阿片类物质成瘾男性患者60例,随机分为两组(n=30):右美托咪定组(D组)术前静脉输注右美托咪定负荷量1μg/kg,维持剂量为0.4μg/(kg·h);对照组(C组)术前静脉输注50 mL 0.9%生理盐水;记录全麻脱毒过程中患者的血流动力学参数,使用客观阿片类物质戒断评分和主观阿片类物质戒断评分评估麻醉中与麻醉复苏后的患者戒断症状;使用101点口述描绘评分法评估患者满意度。结果:全麻脱毒过程中,对照组的心率、收缩压显著增加(P<0.05);对照组脱毒中和脱毒后的客观阿片类物质戒断评分均显著高于右美托咪定组(P<0.05);对照组脱毒后主观阿片类物质戒断评分显著高于右美托咪定组(P<0.05)。右美托咪定组的满意度显著高于对照组(P<0.05)。结论:右美托咪定能够显著减少全麻下快速脱毒中患者的戒断症状,满意度更高。更多还原

【Abstract】 Objective To investigate the effects of dexmedetomidine in preventing the withdrawal symptoms by ultra-rapid detoxification under general anesthesia(GA) in patients addicted to opioids. Methods Sixty male patients who were addicted to opioids were assigned to one of the two groups(n = 30 each): dexmedetomidine group(group D) and control group(group C). A loading dose of dexmedetomidine 1 μg/kg was injected by bolus injection intravenously at preanesthesia,followed by infusion at 0.4 μg /(kg·h) in group D. 50 mL 0.9% saline was injected by bolus injection intravenously at preanesthesia in group C. Hemodynamic changes and withdrawal symptoms during anesthesia and after recovery from anesthesia were assessed using Objective Opiate Withdrawal Scale(OOWS) and Subjective Opiate Withdrawal Scale(SOWS). Patient satisfaction was assessed using 101-point verbal rating scale.Results Hemodynamic data showed that there were statistically significant increases in heart rate and systolic blood pressure during anesthesia in control group(P < 0.05). Control group had significantly higher OOWS score during anesthesia and after recovery from anesthesia than the dexmedetomidine group(P < 0.05). Control group had significantly higher SOWS score after recovery from anesthesia than the dexmedetomidine group(P < 0.05). Patient satisfaction was significantly greater in dexmedetomidine group than in control group(P < 0.05). Conclusion Dexmedetomidine had shown to decrease markedly the withdrawal symptoms when used during ultra-rapid opiate detoxification under GA, and the patients in this group were more satisfied.更多还原