本文關(guān)鍵詞：右美托咪定不同用法在懸雍垂腭咽成形術(shù)患者全麻中的應用　出處：《山東醫(yī)藥》2015年20期 　論文類型：期刊論文

  更多相關(guān)文章： 右美托咪定 曲馬多 阻塞性睡眠呼吸暫停綜合征 蘇醒質(zhì)量

【摘要】：目的觀察右美托咪定不同用法在懸雍垂腭咽成形術(shù)(UPPP)患者全麻中的應用效果。方法阻塞性睡眠呼吸暫停低通氣綜合征擇期全麻下行UPPP患者120例,將患者隨機均分為4組各30例:D1組為氣管插管前15 min,靜脈持續(xù)泵注右美托咪定0.5μg/kg至手術(shù)結(jié)束前30 min;D2組為手術(shù)結(jié)束前30 min,靜脈持續(xù)泵注右美托咪定1μg/kg 15 min;D3組手術(shù)結(jié)束即刻靜脈持續(xù)泵注右美托咪定1μg/kg,至患者蘇醒拔管;對照組(C組)手術(shù)結(jié)束前10 min靜脈注射曲馬多2 mg/kg。記錄入室(T0)、拔管前2 min(T1)、拔管即刻(T2)、拔管后2 min(T3)、進入麻醉恢復室10 min(T4)的HR、MAP、Sp O2,計算拔管時間,拔管后行Ramsay評分評估蘇醒期躁動,PACU行VAS評估術(shù)后疼痛。結(jié)果與C組比較,D1、D2、D3組循環(huán)穩(wěn)定,拔管時間延長,蘇醒期躁動及術(shù)后疼痛發(fā)生率明顯降低,P均0.05;與D1組比較,D2、D3組拔管時間縮短,D3組拔管時間最短,P均0.05;拔管質(zhì)量評分比較,D1、D2、D3組拔管平穩(wěn),優(yōu)于C組,D1、D2組優(yōu)于D3組,P均0.05;蘇醒期躁動及術(shù)后疼痛發(fā)生率D3組高于D1、D2組,P均0.05。結(jié)論全麻UPPP患者手術(shù)結(jié)束前30 min靜脈持續(xù)泵注右美托咪定1μg/kg 15 min,拔管平穩(wěn),蘇醒質(zhì)量高。
[Abstract]:Objective to observe the different usage of dexmetomidine in uvulopalatopharyngoplasty (UPPP). Methods 120 patients with obstructive sleep apnea hypopnea syndrome were treated with UPPP under elective general anesthesia. All the patients were randomly divided into 4 groups (n = 30): 15 min before tracheal intubation, 0.5 渭 g / kg dexmetomidine by intravenous infusion until 30 min before the end of operation. Group D2 received intravenous infusion of dexmetomidine 1 渭 g / kg for 15 min at 30 min before the end of operation. In group D 3, intravenous continuous infusion of dexmetomidine 1 渭 g / kg was performed immediately after operation, and the patients recovered from extubation. Group C (n = 10) tramadol (2 mg / kg) was injected intravenously 10 min before the end of operation. Two minutes after extubation, HRMAP-SpO2 was entered into the anesthetic recovery room (10 mins, T4), and the extubation time was calculated. After extubation, Ramsay score was used to evaluate the postoperative pain of restless PACU in recovery phase. Results compared with group C, the circulation of group D _ 1 and D _ 2C was stable, and the time of extubation was prolonged. The incidence of restlessness and postoperative pain was significantly decreased by 0.05 in the recovery period. Compared with D1 group, the shortest extubation time of D2 + D3 group was shortened (P < 0.05), and the shortest extubation time of D3 group was significantly shorter than that of D _ 1 group (P < 0.05). The quality score of extubation was more stable than that of group D _ 1 and D _ 2 and D _ 2, and better than that of group D _ 1 and D _ 2 than that of group D _ 3 (P < 0.05). The incidence of restlessness and postoperative pain in group D _ 3 was higher than that in group D _ 1 and D _ 2. Conclusion the intravenous infusion of dexmetomidine 1 渭 g / kg for 15 min 30 min before the end of general anesthesia in UPPP patients had stable extubation and high recovery quality.
【作者單位】： 天津市人民醫(yī)院;
【分類號】：R614
【正文快照】： 阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)是一種日益增多的全身性疾病,影響患者的生活質(zhì)量和壽命。懸雍垂腭咽成形術(shù)(UPPP)是外科治療OSAHS的最主要手段,屬于高危手術(shù)。UPPP術(shù)后患者咽喉部疼痛很明顯,蘇醒期疼痛常引起患者躁動;術(shù)后呼吸道梗阻癥狀不會馬上消失,過度鎮(zhèn)靜又會加

【參考文獻】

相關(guān)期刊論文 前10條

1 李民;張利萍;吳新民;;右美托咪啶在臨床麻醉中應用的研究進展[J];中國臨床藥理學雜志;2007年06期

2 楊麗;;冠心病與阻塞性睡眠呼吸暫停綜合征的相關(guān)性研究[J];當代醫(yī)學;2014年36期

3 陳曉影;蔣俊丹;陳彥青;鄒聰華;;右美托咪定在小兒鼾癥手術(shù)拔管期的應用[J];臨床麻醉學雜志;2011年06期

4 康于慶;冷玉芳;薛興;張悅;張艷;汪濤;;右美托咪定對高血壓患者全麻氣管拔管反應及蘇醒時間的影響[J];臨床麻醉學雜志;2011年08期

5 姜西剛;卞清明;辜曉嵐;;右美托咪定復合氟比洛芬酯預防全麻蘇醒期躁動的臨床研究[J];臨床麻醉學雜志;2014年06期

6 劉紀澤;楊光;曾憲陽;李桂芹;刁玉剛;;右美托咪啶用于OSAHS患者鼻內(nèi)窺鏡手術(shù)的臨床觀察[J];遼寧醫(yī)學雜志;2014年06期

7 張莉莉;趙敏;翟金林;;右美托咪啶與咪達唑侖用于腭咽成型術(shù)后躁動的對比研究[J];齊齊哈爾醫(yī)學院學報;2011年18期

8 何晉喜;王建光;劉海健;;右美托咪定對神經(jīng)外科手術(shù)患者全身麻醉后蘇醒期躁動的影響[J];山東醫(yī)藥;2011年43期

9 錢鳳文;李志剛;崔如眾;;阻塞性睡眠呼吸暫停綜合征與2型糖尿病的關(guān)系[J];山東醫(yī)藥;2014年05期

10 張貝貝;朱慧慧;李超偉;孟凡民;劉賀;;右美托咪定靜脈泵注聯(lián)合七氟烷吸入誘導在宮腔鏡手術(shù)麻醉中的應用[J];山東醫(yī)藥;2014年30期

【共引文獻】

相關(guān)期刊論文 前10條

1 楊e，

本文編號：1428384