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-  2017 

右美托咪定在预防悬雍垂腭咽成形术患者术后苏醒期躁动中的应用 Effect of Dexmedetomidine on Emergence Agitation in Patients with Obstructive Sleep Apnea Hypopnea Syndrome After Uvulopalatopharyngoplasty Surgery

Keywords: 右美托咪定,单次负荷剂量,阻塞性睡眠呼吸暂停低通气综合征,悬雍垂-腭-咽成形术,苏醒期躁动

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Abstract:

目的:观察右美托咪定(DEX)不同单次负荷剂量预防中重度阻塞性睡眠呼吸暂停低通气综合征患者择期悬雍垂-腭-咽成形术术后苏醒期躁动的效果。方法:90例30-60岁择期行悬雍垂-腭-咽成形术的患者随机双盲分为三组:对照组(A组)、低剂量右美托咪定组(B组)及高剂量右美托咪定组(C组)。麻醉诱导前,B组和C组患者分别给予单次负荷剂量0.4μg/kg或0.8μg/kg的DEX,20min泵注完。监测HR、SpO_2及NIBP,PACU中记录Riker镇静和躁动评分(SAS)、视觉模拟评分(VAS)和Ramsay镇静评分(RSS)。结果:各组SAS和VAS评分在气管导管拔除即刻的差异有统计学意义(P<0.05);C组RSS评分低于A组(P<0.05);B组SAS评分在气管导管拔除即刻、拔管后10min、拔管后20min和拔管后30min均低于A组(P<0.05);C组SAS评分在拔管后60min时间点之外的各时间点均低于A组(P<0.05);C组患者在拔管后10 min的VAS评分明显低于A组(P<0.05)。结论:单次负荷剂量右美托咪定能有效预防中重度阻塞性睡眠呼吸暂停低通气综合征手术治疗患者苏醒期躁动,其治疗作用呈剂量依赖性

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