摘要目的 观察盐酸右美托咪定对悬雍垂腭咽成形术(UPPP)患者拔管期应激反应的影响.方法 将全麻行UPPP的86例患者随机分为右美托咪定组(50例)和对照组(36例).所有患者术毕均转入麻醉后恢复室泵注丙泊酚、舒芬太尼持续镇静镇痛,右美托咪定组缓慢静脉注射盐酸右美托咪定0.5 μg/kg,对照组给予等量生理盐水.两组均机械通气6～24h后拔管.记录两组患者的苏醒情况、镇静镇痛药物使用量和不良反应发生情况.结果 两组患者的苏醒情况比较差异无统计学意义(P＞0.05).右美托咪定组患者丙泊酚、舒芬太尼的平均((x)±s)使用剂量分别为(777±64) mg、( 174±10) μg,明显少于对照组(941±100) mg、( 207±14)μg(t值分别为4.15和2.99,P值均＜0.05)；右美托咪定组呛咳、躁动、寒战、恶心、呕吐等不良反应的发生率也低于对照组(卡方检验,P值均＜0.01).结论 盐酸右美托咪定可有效抑制UPPP患者术毕拔管期的应激反应,降低术后并发症发生率.

abstractsObjective To observe the effect of dexmedetomidine hydrochloride on stress responses during extubation in patients undergoing uvulopalatopharyngoplasty (UPPP).Methods Eighty-six patients scheduled for UPPP under general anesthesia were randomly divided into dexmedetomidine group (group D,n =50) and control group (group C,n =36).All patients were transported into post anesthesia care unit (PACU) after surgery and maintained sedation and analgesia by infusing propofol and sufentanil.Patients in group D were administrated dexmedetomidine 0.5 μg/kg,patients in group C were administrated equivalent volume of normal saline.Both groups were treated with mechanical ventilation 6 - 24 h before extubation.The dosage of sedative and analgesic drugs and side effects in recovery time were recorded.Results There were no significant differences between two groups in recovery time (P ＞ 0.05 ).The dosage of propofol and sufentanil in group D were (777 ±64)mg,( 174 ± 10) μg respectively,significantly less than that in group C (941 ± 100 ) mg,(207 ± 14 ) μg ( t =4.15 and 2.99,P ＜ 0.05 ).The rate of coughing,restlessness,nausea,vomiting and shivering in group D was lower than that in group C (x2 test,P ＜0.01 ).Conclusion Dexmedetomidine hydrochloride could efficiently restrain the stress response around tracheal extubation,reduce postoperative complications in patients undergoing UPPP.