摘要目的 观察持续输注不同剂量右美托咪定对内窥镜鼻窦手术患者麻醉复苏期的影响.方法 选取本院2014年8月至2015年6月择期全麻内窥镜鼻窦手术成年患者60例随机分为右美托咪定0.2 μg· kg-1· h-1输注组(D1组)、右美托咪定0.5 μg· kg-1· h-1输注组(D2组)和对照组(C组),每组20例.观察麻醉复苏时间及血流动力学变化,SAS评分及EA评分变化及不良事件的次数.结果 C组SBP、DBP在气管拔管时(T1)、拔管后10 min(T2)明显高于结束前(T0)(P＜0.05),D1、D2组SBP、DBP无明显变化,三组HR在T1均明显高于T0(P＜0.05).D1、D2组T1、T2、T3(拔管后30min)点SBP、HR较C组均明显降低(P＜0.05);T1、T2点的DBP较C组明显降低(P＜0.05).三组患者麻醉复苏时间比较差异无统计学意义(P＞0.05),气管拔管时D2组患者SAS、EA评分低于C组及D1组(P＜0.05).D2组患者恶心呕吐、寒颤的发生率少于C组及D1组(P＜0.05).结论 内窥镜鼻窦手术持续输注0.5 μg·kg-1·h-1右美托咪定,有利于维持复苏期血流动力学平稳,减少躁动,不延长复苏时间.

abstractsObjective To investigate the effects of continuous Dexmedetomidine infusion given at different doses on anesthesia recovery period in endoscopic sinus surgery.Methods Between August 2014 to June 2015,60 adult patients undergoing elective endoscopic sinus surgery under general anesthesia in our hospital were randomized to 0.2 μg· kg-1· h-1 Dexmedetomidine infusion group (group D1),0.5 μg· kg-1· h-1 Dexmedetomidine infusion group (group D2) and control group (group C),with 20 patients in each group.We recorded the time of anesthesia recovery,changes in hemodynamics,SAS score and EA score changes,and incidence of adverse events in all groups.Results In Group C,the values of SBP and DBP during extubation (T1) and at 10 min after extubation (T2) were significantly higher than that before the end of surgery (T0) (both P＜0.05).In groups D1 and D2,the SBP and DBP did not change.The HR in the three groups was significantly higher at T1 than at T0 (P＜0.05).In groups D1 and D2,the SBP and HR at T1,T2 and T3 (30 min after extubation) (P＜0.05),and DBP at T1 and T2,were significantly lower than those in group C (all P＜0.05).There was no statistically significant difference in length of anesthesia recovery period among the three groups of patients (P＞0.05).At extubation,patients in group D2 had lower SAS and EA scores than those in groups C and D1 (P＜0.05).Patients in group D2 had less nausea,vomiting and chills compared with those in groups C and D1 (P＜P ＜0.05).Conclusion Continuous Dexmedetomidine infusion given at 0.5 lμg· kg-1· h-1 during endoscopic sinus surgery helps maintain steady hemodynamics during anesthesia recovery period,reduce patient agitation,and does do not prolong the length of recovery period.