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右美托咪定对老年患者脊柱手术苏醒期躁动的影响 被引量:4

Effects of dexmedetomidine on emergence agitation in elderly patients after spinal surgery
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摘要 目的 观察右美托咪定对老年患者脊柱手术后苏醒期躁动(EA)的影响.方法 老年患者(年龄≥60岁)60例,随机分为右美托咪定组(D组)和对照组(C组),每组30例.麻醉诱导后D组患者持续泵注右美托咪定每小时0.4 μg/kg,C组持续泵注等容量的生理盐水,手术结束时停药.入麻醉恢复室(PACU)后进行Richmond躁动镇静(RASS)评分,记录EA发生率.记录患者清醒时间、气管导管拔除时间及PACU停留时间.术后24小时记录患者对苏醒期治疗的满意度.结果 D组患者EA发生率为16.67%,C组为46.67%,两组比较差异有统计学意义(P<0.05),D组患者PACU停留时间为(42.17±17.40)分钟,C组为(52.50±22.12)分钟,两组比较差异有统计学意义(P<0.05).D组患者清醒时间为(16.67 ±7.58)分钟,拔管时间为(21.67±7.58)分钟,C组分别为(14.40±8.47)分钟和(19.10±8.86)分钟,两组比较差异无统计学意义(P>0.05).结论 右美托咪定可以有效地降低老年患者脊柱手术后EA发生率,提高患者苏醒质量. Objective To investigate the effects of dexmedetomidine on emergence agitation dur- ing recovery after spinal surgery in elderly patients. Methods A total of 60 elderly patients ( age≥ 60 ) were randomly assigned to dexmedetomidine group ( group D, n = 30 ) and propofol group ( group C, n = 30). The group D received dexmedetomidine at a rate of μg/(kg· h)from induction of anesthesia until the end of suegery, while the group C received volume-matched saline infusion as placebo. The incidence of agitation, haemodynamic parameters, and recovery characteristics were evaluated in post-anesthesia care unit (PACU). Rusults The incidence of emergence agitation was lower in group D than group C (16.67% vs 46.67%, n = 0. 013 ); time to PACU discharge in group D was shorter than group C [ (42.17 ± 17.40) rain vs (52.50 ± 22.12 ) min, n = 0.049 ]. Time to awake and time to extubation were similar between the groups. Conclusion Dexmedetomidine may be an effective intraoperative adjuvant for a reducing emergence agitation from anaesthesia and it may improve the quality of recovery after spinal surgery in elderly patients.
作者 樊玉花 项明琼 马宇 FAN Yuhua ,XIANG Mingqiong ,MA Yu. (Department of Anesthesiology, Changhai Hospital, the Second Military Medical University, Shanghai 200433, China)
出处 《临床外科杂志》 2016年第8期626-628,共3页 Journal of Clinical Surgery
关键词 脊柱手术 右美托咪定 苏醒期躁动 老年 elderly patients spinal surgery dexmedetomidine emergence agitation
作者简介 通信作者:马宇,Email,ma_yu@126.com
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