【摘要】 目的分析不同剂量右美托咪定对麻醉维持自主呼吸恢复时间、定向力恢复时间及不良反应发生率的影响。方法前瞻性研究,选择苏州大学附属第一医院行腹腔镜全麻手术的患者120例,随机分为4组,对照组给予生理盐水,A组、B组、C组给予右美托咪定,麻醉剂量分别为0.25μg/kg、0.50μg/kg、1.00μg/kg。记录各组患者自主呼吸恢复时间、苏醒时间、定向力恢复时间、拔管时间;停药后各时间点Ramsay镇静评分;记录术后认知功能障碍发生率及其他不良反应发生率。结果 C组自主呼吸恢复时间、苏醒时间、拔管时间、定向力恢复时间均为最短,其次为B组、A组、对照组,组间比较差异有统计学意义(P<0.05)。各时间点Ramsay镇静评分由高到低依次为对照组、A组、B组、C组,组间比较差异有统计学意义(P<0.05)。认知功能障碍发生率从高到低依次为对照组、A组、B组、C组,组间比较差异有统计学意义(P<0.05)。躁动、寒战发生率由高到低依次为对照组、A组、B组和C组,组间比较差异有统计学意义(P<0.05)。结论右美托咪定麻醉剂量为0.50μg/kg和1.00μg/kg时,在腹腔镜全麻手术者麻醉维持中具有较好效果,能加快自主呼吸恢复和定向力恢复,抑制不良反应,术后认知功能恢复较好;考虑1.00μg/kg可能增加镇静过深、低血压、寒战、躁动等风险,推荐剂量为0.5μg/kg。更多还原

【Abstract】 Objective To analyze the effects of Dexmedetomidine on the recovery time,orientation recovery time and adverse reaction incidence of the anesthetic. Methods One hundred and twenty patients underwent laparoscopic general anesthesia at the First Affiliated Hospital of Soochow University were randomly divided into 4 groups: control group using normal saline,group A,group B,group C anesthesia were 0. 25 μg/kg,0. 50 μg/kg,1. 00 μg/kg of Dexmedetomidine. The time of spontaneous respiration recovery time,recovery time,orientation recovery time and time of tube extraction were recorded. Ramsay sedative scores after stopping the drug; The incidence of postoperative cognitive dysfunction and other adverse reactions were recorded. Results The recovery time,wake time,time of extraction and the time of reorientation of group C were theshortest,followed by group B,group A and control group. At each time point,Ramsay sedation score from high to low was control group,group A,group B and group C. The incidence of cognitive dysfunction was in the control group,group A,group B,and group C in the higher order. The incidence of restlessness and chills was significantly different from high to low in the control group,group A,group B and group C. The above comparison is P < 0. 05. Conclusion 0. 50 μg/kg and 1. 00 μg/kg Dexmedetomidine used in laparoscopic surgery anesthesia to maintain general anesthesia has good effect,can accelerate the spontaneous breathing and directional force recovery,inhibition of adverse reaction,better recovery of cognitive function. Considering that 1. 00 μg/kg may increase the risk of sedation,hypotension,chills,and restlessness,this study recommends a dose of 0. 5 μg/kg.更多还原