不同剂量右美托咪定预防肝癌根治术患者苏醒期不良反应效果观察

    Clinical observation of different doses of dexmedetomidine in the prevention of the adverse reaction in the patients treated with resection of hepatocellular carcinoma during recovery period

    • 摘要: 目的:观察不同剂量右美托咪定对肝癌根治术患者全麻苏醒期不良反应的影响。方法:60例择期行肝癌根治术的患者,随机分为右美托咪定1组(D1组)、右美托咪定2组(D2组)和对照组(C组)各20例,D1、D2组分别在手术结束前30 min微量泵持续静脉输注右美托咪定0.5μg/kg和1μg/kg,输注时间10 min,对照组持续输注同等容量0.9%氯化钠注射液。观察3组苏醒期循环情况、苏醒时间及拔管时间,同时观察躁动评分和镇静评分。结果:D1和D2组围拔管期各时点的血压、心率及术后躁动评分等均显著低于C组,而镇静评分显著高于C组(P<0.01),D1组苏醒时间及拔管时间与C组比较差异无统计学意义(P>0.05),而D2组苏醒时间及拔管时间均显著长于C组和D1组(P<0.01)。结论:手术结束前30 min静脉输注右美托咪定0.5μg/kg,可更好地维持肝癌根治术患者全麻苏醒期的血流动力学稳定,减少躁动,且不影响麻醉的苏醒时间。

       

      Abstract: Objective: To investigate the effects of the different doses of dexmedetomidine on the adverse reactions in the patients treated with resection of hepatocellular carcinoma during recovery period.Methods: Sixty patients scheduled by resection of hepatocellular carcinoma were randomly divided into the dexmedetomidine 1 and 2 group(D1 and D2 group) and control group.D1 and D2 group were treated with 0.5μg/kg and 1μg/kg of dexmedetomidine by continuously intravenous injection for 10 min before 30 min of the end of operation,respectively,and the control group were treated with the same volume 0.9% sodium chloride injection.The blood circulation,awakening and extubation time,and restlessness and sedation score in 3 groups during recovery period were observed.Results: The blood pressure and heart rate at each time-point during peri-extubation and postoperative restlessness score in D1 and D2 groups were significantly lower than those in control group(P<0.01),while the sedation score in D1 and D2 groups was significantly higher than that in control group(P<0.01).The differences of the awakening time and extubation time between D1 group and control group were not statistically significant(P>0.05),while the awakening time in D2 group was significantly longer than that in control and D1 groups(P<0.01).Conclusions: The intravenous injection with 0.5μg/kg of dexmedetomidine at 30 min before the end of operation can keep the stabilization of hemodynamics during recovery period,reduce the restlessness,and does not affect the awakening time in the patients with resection of hepatocellular carcinoma.

       

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