|
| 右美托咪定复合氟哌利多对七氟醚全麻胸科手术老年患者苏醒期躁动的影响 |
| Effect of combination of dexmedetomidine and droperidol on emergence agitation of sevoflurane general anesthesia in the elderly undergoing thoracotomy |
| |
| DOI：10.12089/jca.2019.02.007 |
| 中文关键词: 右美托咪定 氟哌利多 苏醒期躁动 老年 七氟醚 术后并发症 |
| 英文关键词: Dexmedetomidine Droperidol Emergence agitation Aged Sevoflurane Postoperative complications |
| 基金项目: |
| 作者 | 单位 | E-mail | | 陈齐 | 230601,合肥市,安徽医科大学第二附属医院麻醉与围术期医学科 | | | 张野 | 230601,合肥市,安徽医科大学第二附属医院麻醉与围术期医学科 | zhangye_hassan@sina.com | | 宋永生 | 230601,合肥市,安徽医科大学第二附属医院麻醉与围术期医学科 | | | 盛奎 | 230601,合肥市,安徽医科大学第二附属医院麻醉与围术期医学科 | | | 蒋玲玲 | 230601,合肥市,安徽医科大学第二附属医院麻醉与围术期医学科 | | | 黄春霞 | 230601,合肥市,安徽医科大学第二附属医院麻醉与围术期医学科 | | | 胡宪文 | 230601,合肥市,安徽医科大学第二附属医院麻醉与围术期医学科 | |
|
| 摘要点击次数: 3053 |
| 全文下载次数: 944 |
| 中文摘要: |
目的 评价右美托咪定复合氟哌利多治疗七氟醚全麻胸科手术老年患者苏醒期躁动的有效性及安全性。
方法 选取七氟醚全麻下普胸外科术后严重躁动老年患者60例，男48例，女12例，年龄66~75岁，ASA Ⅱ或Ⅲ级，按照随机数字表分为三组：氟哌利多组（F组）、右美托咪定组（D组）和右美托咪定复合氟哌利多组（DF组）。被诊断为苏醒期严重躁动后，F组静脉推注氟哌利多0.06 mg/kg;D组右美托咪定1 μg/kg泵注10 min，继以0.2 μg·kg-1·h-1维持泵注1 h;DF组静脉推注氟哌利多0.03 mg/kg，同时给予右美托咪定0.5 μg/kg泵注10 min，继以0.2 μg·kg-1·h-1维持泵注1 h。观察并记录躁动评分、Ramsay镇静评分、PaCO2变化以及恶心、呕吐等不良反应的发生情况。
结果 给药后5、10、15、20 min DF组躁动评分明显低于D组（P<0.05）;给药后60、90、120 min DF组躁动评分明显低于F组（P<0.05）。给药后60、120 min三组PaCO2差异无统计学意义。DF组和D组过度镇静比例明显低于F组（P<0.05）。三组恶心、呕吐、心动过缓、高血压、低血压发生率差异无统计学意义。
结论 右美托咪定复合氟哌利多用于老年患者七氟醚全身麻醉苏醒期躁动的治疗效果确切，安全性好，可以规避右美托咪定不能快速推注同时避免氟哌利多导致过度镇静的缺点。 |
| 英文摘要: |
Ojective To evaluate the treatment effect of combination of dexmedetomidine and droperidol on emergence agitation during general anesthesia recovery period in the elderly undergoing thoracotomy.
Methods Sixty patients with severe emergence agitation during general anesthesia recovery period undergoing thoracotomy for esophageal cancer or pulmonary lobectomy, aged 66 - 75 years, falling into ASA physical status Ⅱ or Ⅲ, were divided into three groups, 20 patients in each according to table of random number: group droperidol (group F) and group dexmedetomidine (group D) and group dexmedetomidine combining droperidol (group DF). In group F, 0.06 mg/kg droperidol was administrated via central vein. In group D, 1 μg/kg dexmedetomidine was pumped via central vein in 10 min, followed by continuous infusion of dexmedetomidine in 0.2 μg·kg-1·h-1 for 1 h. While in group DF, 0.03 mg/kg droperidol was administrated via central vein and 0.5 μg/kg dexmedetomidine was pumped via central vein in 10 min, then followed by continuous infusion of dexmedetomidine in 0.2 μg·kg-1·h-1 for 1 h. The agitation scores and the Ramsay scores were collected after the beginning of anti-agitation. Arterial blood partial pressure of carbon dioxide was tested. Postoperative complications including nausea and vomiting were recorded.
Results Compared with group D，the agitation scores at 5, 10, 15 and 20 min in group DF were lower (P < 0.05). Comparing with group F, the agitation scores at 60, 90 and 120 min in group DF were lower (P < 0.05). The incidence of over-sedation in group DF and in group D was less than that in group F (P < 0.05). PaCO2 was unaltered in all the groups after treatment. The incidence of nausea, vomiting, bradycardia, hypertension, hypotension and respiration depression and long QT interval between the groups were comparable.
Conclusion Combination of dexmedetomidine and droperidol is effective and safe in the treatment of agitation during sevoflurane general anesthesia recovery period in the elderly undergoing thoracotomy. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
