南方医科大学学报

南方医科大学学报 ›› 2013, Vol. 33 ›› Issue (08): 1194-.

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小剂量右美托咪啶对脊柱后路手术患者苏醒期的影响

谭志敏，彭爱霞，袁清华，段鲁，李玉娟   

  • 出版日期:2013-08-20 发布日期:2013-08-20

Influence of small-dose dexmedetomidine on recovery of patients undergoing vertebral operation

  • Online:2013-08-20 Published:2013-08-20

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摘要： 目的观察术中维持输注小剂量右美托咪啶对脊柱后路手术患者苏醒期的影响。方法选择择期行脊柱后路内固定手术患
者60例，ASA Ⅰ~Ⅱ级，随机双盲分成2组（n=30）：Ⅰ组气管插管后右美托咪啶以0.5 μg/（kg·h）的速度维持输注至手术缝合切
口前；Ⅱ组以0.9%生理盐水替代，以相同方法术中维持输注。观察和记录手术结束后患者自主呼吸恢复时间（T1）、呼之睁眼时
间（T2）及清醒拔管时间（T3）；记录各时点及拔管后1 min（T4）、10 min（T5）、30 min（T6）病人的平均动脉压、心率、Riker镇静躁动
评分及Ramesay镇静评分。结果Ⅰ组患者呼吸恢复时间及睁眼时间大于Ⅱ组，拔管时间小于Ⅱ组（P<0.05）；T2及T4时点Ⅱ组
Riker镇静躁动评分明显高于Ⅰ组，T1、T2及T5时点Ⅰ组Ramesay镇静评分明显高于Ⅱ组（P<0.05）；两组患者术后各时点的平均
动脉压、心率，Ⅰ组明显低于Ⅱ组（P<0.05），T3、T4时更加显著（P<0.01）；每组平均动脉压和心率在T3、T4时均比其余时点明显升
高（P<0.05）。结论术中维持输注小剂量右美托咪啶可以很好的预防脊柱后路手术术后苏醒期患者的躁动，降低苏醒期风险和
患者痛苦。

Abstract: Objective To evaluate the influence of small-dose dexmedetomidine infusion on recovery of patients undergoing
vertebral operation. Methods Sixty ASA I-II patients undergoing vertebral operation were randomly divided into two groups
(n=30). In group I, dexmedetomidine infusion was pumped at the rate of 0.5 μg·kg-1·h-1 from tracheal intubation to incision
suture, and in group II, 0.9%saline was pumped instead. The mean arterial pressure, heart rate, Riker Sedation-Agitation Scale
and Ramesay sedation score were recorded at the time points of autonomous respiration (T1), eye opening (T2), extubation (T3),
1 min after extubation (T4), 10 min after extubation (T5), and 30 min after extubation (T6). Results The recovery time of
autonomous respiration and eye opening time in group I were significantly longer than those in group II, and the extubation
time was significantly shorter in group I (P<0.05). Riker Sedation-Agitation Scale scores in group II were significantly higher
than those in group I at T2 and T4, and Ramesay sedation scores in group I were significantly higher than those in group II at T1,
T2 and T5 (P<0.05). The mean arterial pressure and heart rate at each time point was significantly lower in group I than in group
II (P<0.05), especially at T3 and T4 (P<0.01). In both groups, the mean arterial pressure and heart rate at T3 and T4 were
significantly higher than those at rest (P<0.05). Conclusion Small-dose dexmedetomidine infusion can reduce dysphoria and
lower the risks during recovery from general anesthesia following vertebral operation.