| 丙泊酚序贯右美托咪定对成人全身麻醉苏醒期躁动的治疗作用研究 |
| 投稿时间：2016-06-20 修订日期：2016-06-23 点此下载全文 |
| 引用本文：樊玉花,薄禄龙,项明琼,张文汇,马宇.丙泊酚序贯右美托咪定对成人全身麻醉苏醒期躁动的治疗作用研究[J].医学研究杂志,2017,46(2):55-58 |
| DOI：
10.11969/j.issn.1673-548X.2017.02.016 |
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| 基金项目:国家临床重点专科军队建设项目；上海青年医师资助计划项目（20141093） |
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| 中文摘要:目的 观察丙泊酚序贯右美托咪定对成人患者苏醒期躁动（EA）的治疗效果。方法 气管插管全身麻醉后发生EA、RASS评分≥2分的成人患者40例，采用数学表法随机分为丙泊酚序贯右美托咪定组（A组）和丙泊酚组（B组），每组各20例。两组患者发生EA时，均立即经静脉给予丙泊酚0.5mg/kg，随后A组给予右美托咪定0.5μg/kg，微泵静脉注射10min；B组给予丙泊酚1mg/kg，微泵静脉注射10min。经上述治疗后若患者仍有躁动表现，则予丙泊酚0.5mg/kg静脉注射，直至RASS评分=0分或患者无躁动、可正常交流。结果 两组患者治疗前RASS评分无差别（P>0.05）。与B组相比，A组患者EA治疗时间、PACU停留时间显著缩短，苏醒期丙泊酚额外用量减少，差异有统计学意义（P<0.05）。两组患者EA均得到有效治疗，治疗期间无心律失常、呼吸抑制等并发症发生。术后24h随访时，两组患者均对EA期间无不良记忆，满意度高，差异无统计学意义（P>0.05）。结论 丙泊酚序贯右美托咪定可有效地治疗苏醒期躁动，有缩短EA治疗时间及PACU停留时间，减少额外镇静药物用量的优势，更适于全身麻醉后EA的治疗。 |
| 中文关键词:苏醒期躁动 丙泊酚 右美托咪定 |
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| Effects of Dexmedetomidine Combined with Propofol in Emergence Agitation During Recovery After General Anesthesia in Adult Patients |
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| Abstract:Objective To observe the effects of dexmedetomidine combined with propofol in emergence agitation during recovery after general anesthesia in adult patients. Methods Forty patients, with RASS score ≥2, suffering from emergence agitation after general anesthesia, were randomly assigned to dexmedetomidine combined with propofol group(group A, n=20) and propofol group(group B, n=20). Patients in group A were administered with dexmedetomidine at a dose of 0.5μg/kg in 10mins, whereas patients in group B received intravenous propofol at a dose of 1mg/kg in 10mins, respectively. If patients still agitate after above treatment, intravenous propofol 0.5mg/kg was used for further treatment until RASS score=0, patients attain calm state. Results The time to RASS=0, the time to PACU discharge were shorter in group A compared with group B(P<0.05); The postoperative, supplemental propofol medication were significantly decrease in group A compared with group B(P<0.05).Arhythmia and respiratory depression didn't happen in this study. None patients had bad memories of the emergence agitation period, there were no significant differences between two groups in patient's satisfaction degrees(P>0.05). Conclusion Dexmedetomidine combined with propofol can effectively treat the emergence agitation, can shorten the time to RASS=0 and the time to PACU discharge, reduce the dosage of supplemental sedative drug. Dexmedetomidine combined with propofol was more beneficial than propofol in treatment for emergence agitation. |
| keywords:Emergence agitation Propofol Dexmedetomidine |
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