文章摘要
右美托咪定对经鼻中隔-蝶窦垂体瘤切除术患者苏醒期的影响
Effects of dexmedetomidine on the emergence of patients undergoing transnasal transsphenoidal pituitary tumor resection
  
DOI：
中文关键词: 垂体瘤切除术  苏醒期躁动  右美托咪定
英文关键词: Pituitary tumor resection  Emergence agitation  Dexmedetomidine
基金项目:
作者单位
唐帅 100730,中国医学科学院,北京协和医院麻醉科 
薛杨 100730,中国医学科学院,北京协和医院麻醉科 
张良燕 100730,中国医学科学院,北京协和医院麻醉科 
梁蒙 威海市中心医院麻醉科 
邓侃 100730,中国医学科学院,北京协和医院神经外科 
张砡 100730,中国医学科学院,北京协和医院麻醉科 
易杰 100730,中国医学科学院,北京协和医院麻醉科 
张秀华 100730,中国医学科学院,北京协和医院麻醉科 
黄宇光 100730,中国医学科学院,北京协和医院麻醉科 
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中文摘要:
      目的 评估右美托咪定行对经鼻中隔-蝶窦垂体瘤切除术患者苏醒期的影响。方法 选择拟在全麻下行择期垂体瘤切除术患者124例，年龄18～65岁，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者分为右美托咪定组 (D组，n=62)和对照组 (C组，n=62)。两组患者均以丙泊酚、芬太尼、罗库溴铵、地塞米松和昂丹司琼静脉诱导，七氟醚、氧气和氧化亚氮吸入维持，D组术中静脉泵注右美托咪定，C组泵注等量生理盐水，记录两组患者的拔管时间和PACU停留时间;记录苏醒期躁动、呛咳以及术后24 h内咽痛及声音嘶哑的发生情况。结果 共119例最终纳入分析，其中D组57例，C组62例。D组拔管时间［(29.7±11.5)min vs (22.2±8.5)min]和PACU停留时间[(41.5±11.8)min vs (35.3±10.0)min］明显长于C组(P<0.05)。两组苏醒期躁动 (26.3% vs 32.3%)、呛咳 (49.1% vs 53.2%)及术后24 h内咽痛 (14.0% vs 24.2%)和声音嘶哑 (10.5% vs 19.4%)发生率差异无统计学意义。结论 术中使用右美托咪定可提高经鼻中隔-蝶窦垂体瘤切除术患者术后对气管导管的耐受，不影响术后躁动、呛咳、咽痛、声音嘶哑的发生率。
英文摘要:
      Objective To evaluate the effect of dexmedetomidine on the tolerance to endotracheal tube, on agitation and other complications of patients undergoing transnasal transsphenoidal pituitary tumor resection. Methods One hundred and twenty-four patients aged 18-65 years, ASA physical status Ⅰ or Ⅱ) were randomly assigned to dexmedetomidine group (group D, n=60) and control group (group C, n=62). Group D were given intravenous infusion of dexmedetomidine during the operation and group C with saline. The extubation time, observation time in the post-anesthesia care unit (PACU), the incidence of emergence agitation, cough, postoperative sore throat and hoarseness were analyzed. Results The extubation time ［(29.7±11.5) min vs (22.2±8.5) min］ and the length of stay in PACU ［(41.5±11.8) min vs (35.3±10.0) min］ were significantly longer in group D than those in group C (P<0.05). There was no significant difference of the incidence of emergence agitation (26.3% vs 32.3%), cough (49.1% vs 53.2%), postoperative sore throat (14.0% vs 24.2%) and hoarseness (10.5% vs 19.4%) between two groups. Conclusion Intraoperative intravenous administration of dexmedetomidine can prolong the extubation time and the length of stay in PACU. The incidence of agitation, cough, postoperative sore throat and hoarseness was not affected by dexmedetomidine.
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