【摘要】 目的:比较右美托咪定、地佐辛及其二者联合对全身麻醉患者苏醒期躁动及血流动力学的影响,为临床合理用药提供依据。方法:选择符合标准的患者90例,随机分为A组、B组及C组各30例,A组应用右美托咪定、B组应用地佐辛、C组应用右美托咪定及地佐辛,观察并记录三组患者麻醉前(T0)、气管拔管后5min(T1)及气管拔管后10min(T2)时间点的收缩压(SBP)、舒张压(DBP)和心率(HR),同时观察苏醒期躁动发生情况。结果:三组患者在手术时间、术中出血量、术中输入液体量等相似,差异无统计学意义(P>0.05)。三组患者T0时间点SBP、DBP及HR相似,差异无统计学差异(P>0.05)。A组及B组患者T1、T2时间点SBP、DBP及HR相似,差异无统计学差异(P>0.05)。C组患者T1、T2时间点SBP、DBP及HR较A组及B组更稳定,差异具有统计学意义(P<0.05)。三组患者苏醒期均未发生中度躁动、过度镇静和苏醒延迟,发生轻度躁动A组9例、B组10例和C组2例,A组和B组比较,差异无统计学差异(P>0.05);C组躁动发生率明显低于A组和B组,差异具有统计学意义(P<0.05)。结论:右美托咪定联合地佐辛能更有效的稳定全身麻醉患者苏醒期的血压及心率,降低躁动发生几率,值得临床推广应用。更多还原

【Abstract】 Objective: To compare the effect of dexmedetomidine,dezocine and coadministration of them on the hemodynamics and restlessness in the stage of analepsia in patients under general anesthesia,and to provide foundations for clinical rational administration. Method: Ninety eligible patients were selected and randomly divided into group A,group B and group C,with 30 patients in each group; group A used dexmedetomidine,group B used dezocine,and group C used dexmedetomidine and dezocine; the systolic blood pressures( SBP),diastolic blood pressures( DBP) and heart rates( HR) before anesthesia( T0),5min after tracheal extubation( T1) and at 10 min after tracheal extubation( T2) and the restlessness in the stage of analepsia in the patients of the three groups were observed and recorded. Result: The patients of the three groups had similar operative time,intra-operative blood loss,and intra-operative volume of fluid infused,and the differences were statistically insignificant( P > 0. 05). The patients of the three groups had similar SBP,DBP and HR at T0,and the differences were statistically insignificant( P >0.05). The patients of the group A and the group B had similar SBP,DBP and HR at T1 and T2,and the differences were statistically insignificant( P >0.05). The patients of the group C had more stable SBP,DBP and HR at T1 and T2than the patients of the group A and the group B,and the differences were statistically significant( P <0.05).No moderate restlessness,excessive sedation or palinesthesia delay occurred in the patients of the three groups in the stage of analepsia. But mild restlessness occurred in 9 patients of the group A,10 patients of the group B and 2 patients of the group C,the difference between the group A and the group B was statistically insignificant( P >0.05),and the restlessness incidence in the patients of the group C was significantly lower than that of the group B and the group C( P <0.05).Conclusion: Coadministration of dexmedetomidine and dezocine can stabilize the blood pressure and heart rate in the stage of analepsia more effectively,and decrease the incidence of restlessness in patients under general anesthesia,and consequently is worthy of clinical application.更多还原