%0 Journal Article
%T 不同剂量右美托咪定对丙泊酚–芬太尼复合用于宫颈锥切术麻醉效果的影响
Influence of Different Doses of Dexmedetomidine on the Anesthesia Effect of Propofol-Fentanyl Combined in Cervical Conization
%A 蔡胜男
%A 王世端
%A 贾媛芳
%A 米军桥
%A 李欢妮
%J Advances in Clinical Medicine
%P 1294-1300
%@ 2161-8720
%D 2021
%I Hans Publishing
%R 10.12677/ACM.2021.113185
%X
目的：比较复合不同剂量右美托咪定在宫颈锥切术中对患者呼吸、循环及恢复时间的影响。方法：选择择期拟行宫颈锥切术的患者90例，ASA I~II级，年龄18~60岁，体重45~75 kg，BMI 18~28 kg？m？2。按照随机数字表法将患者分为3组，每组30例。D1组、D2组和D3组分别于患者入室后静脉输注右美托咪定0.3、0.6、0.9 μg？kg？1，泵注时间10 min。随后靶控输注丙泊酚(起始靶浓度1.5 μg？mL？1)和静注芬太尼0.5 μg？kg？1复合麻醉。观察并记录各时间点的心率(HR)、平均动脉压(MAP)、呼吸频率(RR)、呼吸末二氧化碳(PETCO2)、丙泊酚效应室浓度(Ce)。记录丙泊酚及芬太尼用量，苏醒时间，恢复时间，不良反应，术后调查术者及患者的满意度。结果：由于影响手术操作，D1组3例患者使用了神级肌肉阻滞剂，排除在研究之外。与D1组相比，D2组患者术中PETCO2和RR均无显著降低，呼吸维持稳定，MAP无显著降低，血流动力学稳定(P < 0.05)。与D3组相比，D2组患者HR无显著降低，血流动力学稳定(P < 0.05)。D1组舌后坠的发生率为51.9%，呼吸暂停发生率为18.5%，血压降低发生率为25.9%，D3组心动过缓发生率为73.3%，与D2组差异显著(P < 0.05)。与D1组相比，D2及D3组丙泊酚和芬太尼用量减少(P < 0.05)。三组患者苏醒时间无显著差异(P > 0.05)，D2、D3组恢复时间更短(P < 0.05)。三组手术时间、患者及术者的满意度无显著差异(P > 0.05)。结论：与0.3 μg？kg？1和0.9 μg？kg？1的右美托咪定相比，0.6 μg？kg？1右美托咪定减少了全麻药物的用量，提供了更稳定的呼吸和血流动力学特征，离室和恢复时间更短。
Objective: To evaluate the effects of different doses of dexmedetomidine on respiration, circulation and recovery time during anesthesia in patients undergoing cervical conization. Methods: Ninety patients, ASA physical status I~II, aged 18~60 years, weighing 45~75 kg, BMI 18~28 kg？m？2, undergoing cervical conization, were randomly divided into groups 0.3 μg？kg？1 (D1), 0.6 μg？kg？1 (D2), 0.9 μg？kg？1 (D3) using a random number table by nurse anesthetist (not participating in observation). Blind method was used in this study. Dexmedetomidine 0.3, 0.6, 0.9 μg？kg？1 were infused intravenously for 10 min before the patients are quiet in groups D1, D2, D3, respectively. And then TCI propofol (the target plasma concentration was set at 1.5 μg？mL？1) and fentanyl 0.5 μg？kg？1 were given. The assessment of HR, MAP, RR, PETCO2, Ce were continuously monitored. Dose of propofol and fentanyl, awakening time, recovery time, the incidence of adverse reaction were also recorded. Satisfaction of surgeons and patients were investigated after surgery. Results: Eighty-seven patients were enrolled, and three patients in group D1 were excluded from the study because of neuromuscular blocking agent use. PETCO2, RR, MAP were not significantly lower in group D2 than in group D1, and respiratory was stable (P < 0.05). HR was not significantly lower in group D2 than in group D3, and the patients were hemodynamically stable (P < 0.05). The rate of glossocoma, apnea and hypotension is 51.9%, 18.5%, 25.9% respectively in
%K 右美托咪定，自主呼吸，麻醉，宫颈锥切术
Dexmedetomidine
%K Automatic Respiratory
%K Anesthesia
%K Conization of Cervix
%U http://www.hanspub.org/journal/PaperInformation.aspx?PaperID=41266