【摘要】 目的:探讨帕瑞昔布钠联合右美托咪定对开胸手术患者苏醒质量及应激反应的影响。方法:选择2014年1月至2016年9月我院行开胸手术的90例患者,通过随机数表法分为观察组(n=45)和对照组(n=45)。观察组在术前30min静脉注射帕瑞昔布,术毕前5 min缓慢静脉注射右美托咪定;对照组在术前、30 min、术毕前5 min给予等容量生理盐水。比较两组苏醒时间、拔管时间以及麻醉诱导前(T1)、手术结束时(T2)、术后3 h(T3)时血糖(Glu)、皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)、运动活动评分(MAAS)的变化,并比较麻醉恢复期躁动的发生率。结果:两组苏醒时间、拔管时间比较差异上无统计学意义(P>0.05);观察组T2、T3时Glu、Cor、E、NE水平以及MAAS评分均明显低于对照组(P<0.05),躁动发生率明显低于对照组(P<0.05)。结论:在开胸手术患者麻醉过程中,应用帕瑞昔布钠联合右美托咪定可有效抑制麻醉恢复期应激反应,减少躁动的发生,提高苏醒质量。更多还原

【Abstract】 Objective: To study the influence of parecoxib sodium combined with dexmedetomidine on the awakening quality and stress response of patients with thoracotomy. Methods: 90 patients of chronic renal failure who were treated from January 2014 to September 2016 in our hospital were selected and divided into the observation group(n=45) and the control group(n=45) according to the random number table. The control group was intravenously injected with parecoxib sodium at 30 min preoperation, slow intravenous dexmedetomidine at 5 min postoperation, the control group was given equal volume of normal saline at 5 min preoperation and 30 min postoperation. The recovery time, extubation time and blood glucose(Glu), cortisol(Cor), epinephrine(E), norepinephrine(NE), motor activity score(MAAS) at before anesthesia induction(T1) and at the end of surgery(T2), postoperative 3h(T3) and the incidence of agitation during anesthesia recovery were compared. Results: There was no significant difference in the recovery time and extubation time between the two groups(P>0.05); the levels of Glu, Cor, E, NE and MAAS score in the observation group were significantly lower than those in the control group at T2 and T3(P<0.05); the incidence of agitation in the observation group was significantly lower than those in the control group(P <0.05). Conclusion: Parecoxib sodium combined with dexmedetomidine was benefical to thoracotomy,which could effectively inhibit the stress response during anesthesia recovery, reduce the incidence of restlessness, improve the quality of awakening.更多还原