本文關(guān)鍵詞：丙泊酚聯(lián)合右美托咪定對術(shù)后恢復(fù)期躁動患者的影響　出處：《廣東醫(yī)學(xué)》2016年21期 　論文類型：期刊論文

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【摘要】：目的觀察丙泊酚聯(lián)合右美托咪定對術(shù)后躁動患者的影響。方法選擇擇期全麻術(shù)后恢復(fù)期發(fā)生躁動同時潮氣量不足的患者40例,ASAⅠ~Ⅱ級,隨機(jī)單盲分成兩組(n=20):對照組單純給予丙泊酚,首劑量0.5~1 mg/kg,靜脈注射,之后根據(jù)情況可多次給藥;觀察組給予丙泊酚首劑量0.5~1 mg/kg,靜脈注射,維持用右美托咪定,1μg/(kg·h),泵注10 min,之后根據(jù)情況可多次給予丙泊酚。記錄患者入恢復(fù)室時(T0)、丙泊酚第1次給藥前(T1)、給藥后(T2)、拔管前(T3)及拔管后5 min(T4)的SAS評分及血壓、心率、血氧飽和度,記錄丙泊酚總給藥量及給藥次數(shù),記錄給藥后至患者清醒拔管的時間及恢復(fù)室總停留時間;術(shù)后隨訪有無術(shù)中知曉情況。結(jié)果T3時對照組的心率及收縮壓明顯高于觀察組,差異有統(tǒng)計學(xué)意義(P0.05),T5時對照組SAS評分明顯高于觀察組,差異有統(tǒng)計學(xué)意義(P0.05),對照組丙泊酚總給藥量及給藥次數(shù)明顯大于觀察組,差異有統(tǒng)計學(xué)意義(P0.05),對照組患者恢復(fù)室停留時間大于觀察組,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論對于發(fā)生恢復(fù)期躁動又未達(dá)到拔管條件的患者泵注小量右美托咪定是有效、可行的,推薦用法是在給予丙泊酚靜脈注射后再泵注右美托咪定。
[Abstract]:Objective to observe the effect of propofol combined with dexmetomidine on postoperative restlessness. Methods 40 patients with restlessness and insufficient tidal volume after elective general anesthesia were selected. They were randomly divided into two groups: the control group was given propofol at the initial dose of 0.5 mg / kg, and was injected intravenously, then the drug could be given several times according to the situation. The first dose of propofol (0.5 mg / kg) was injected intravenously and maintained with dexmetomidine 1 渭 g / kg / kg / h for 10 min. After that, propofol can be given several times according to the situation. The patients were recorded when they entered the recovery room. Before and after the first administration of propofol, T1 and T2 were recorded. SAS score, blood pressure, heart rate, blood oxygen saturation, total dosage and times of administration of propofol were recorded before and 5 min after extubation. The time of extubation and the total residence time of recovery room were recorded. Results the heart rate and systolic blood pressure in the control group were significantly higher than those in the observation group at T3, and the difference was statistically significant (P 0.05). The SAS score in the control group was significantly higher than that in the observation group at T5, and the difference was statistically significant (P 0.05). The total dosage and times of administration of propofol in the control group were significantly higher than those in the observation group. The difference was statistically significant (P 0.05). The recovery room residence time of the control group was longer than that of the observation group. Conclusion it is effective and feasible for patients with restless convalescence who do not reach the extubation condition to pump a small amount of dexmetidine. Recommended use is intravenous injection of propofol followed by intravenous injection of dexmetomidine.
【作者單位】： 贛南醫(yī)學(xué)院第一附屬醫(yī)院麻醉科;
【分類號】：R614
【正文快照】： 全麻手術(shù)蘇醒期的躁動由多方面原因造成,如手術(shù)創(chuàng)傷大、出血多、術(shù)后傷口疼痛、留置導(dǎo)尿管等,常同時存在多種不良刺激,若處理不當(dāng),可引起嚴(yán)重并發(fā)癥甚至危及生命。近年來右美托咪定在臨床麻醉中廣泛應(yīng)用,相關(guān)研究發(fā)現(xiàn)圍術(shù)期應(yīng)用可預(yù)防并減少術(shù)后躁動的發(fā)生,但研究局限于術(shù)前或

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