| 王涛 黄俊梅 王珊珊 谢洁 杨晓明.右美托咪定预防全麻下后路减压椎间植骨融合术后寒战的临床研究[J].,2016,16(4):713-716 |
| 右美托咪定预防全麻下后路减压椎间植骨融合术后寒战的临床研究 |
| A Clinical Study on the Preventive Effect of Dexmedetomidineon the Postoperative Shivering in Patients Undergoing Posterior LumbarInterbody FusionTo |
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| DOI： |
| 中文关键词: 右美托咪定 寒战 全身麻醉 后路减压椎间植骨融合术 |
| 英文关键词: Dexmedetomidine Shivering General anesthesia Posterior lumbar interbody fusion |
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| 中文摘要: |
| 目的：观察右美托咪定对全麻下后路减压椎间植骨融合术(PLIF)后寒战的预防效果。方法：选择行全身麻醉的PLIF手术患者
80例，并将其随机分为高剂量右美托咪定组(HD 组)、中剂量右美托咪定组(MD 组)、低剂量右美托咪定组(LD 组)和对照组(C 组)，
每组20 例患者。HD组、MD 组及LD 组在麻醉诱导后分别以0.8、0.5 及0.2 ug/kg/h 静脉泵注右美托咪定至手术结束前40 min；C
组泵注生理盐水。监测并记录患者麻醉前的基础体温值及BIS值，送入恢复室即刻、20 min、40 min、60 min 的Ramsay 镇静评分
值、体温值；记录各组手术时长、拔管时间、术中输液量及失血量以及心动过缓、恶心、呕吐等不良反应的发生情况和苏醒期各组
寒战程度分级及发生情况。结果：各组患者手术结束时的体温均较基础体温明显降低(P＜0.05)。入恢复室后，HD 组同一时段的
Ramsay镇静评分显著高于其他三组(P＜0.01)。HD 组的拔管时间明显延长(P＜0.01)。与C 组比较，MD 组及HD组术后心动过缓、
口干的发生率明显升高(P＜0.05)，而恶心、呕吐及呛咳的发生率明显降低(P＜0.05)。在恢复室观察期间，MD 组及HD组寒战的发
生率较C 组明显降低(P＜0.01)；MD 组寒战发生率也明显低于LD 组(P＜0.05)。结论：0.5 ug/kg/h 持续泵注右美托咪定可以有效
预防全麻下PLIF手术术后寒战的发生。 |
| 英文摘要: |
| Objective:To observe the preventive effect of dexmedetomidine on the postoperative shivering in patients undergoing
general anesthesia after posterior lumbar interbody fusion.Methods:Eighty patients scheduled for posterior lumbar interbody fusion were
randomly assigned into four groups. After the induction of anesthesia, group HD, group MD and group LD respectively received
intravenous infusion of 0.8 ug/kg/h, 0.5 ug/kg/h and 0.2 ug/kg/h dexmedetomidine until 40 min before the end of operation, while group
C received normal saline infusion. Basal temperatures and values of BIS before anesthesia were monitored and recorded. Ramsay
sedation scores and temperatures were recorded after the patients were sent to the recovery room immediately, 20 min, 40 min and 60
min. The operation time, extubation time, intraoperative transfusion volume and incidence rates of adverse reaction were recorded. The
grades of shivering and incidence rates of shivering of the four groups were also recorded.Results:The temperatures at the end of
operation in each group were lower than the basal temperatures (P<0.05). In the recovery room, Ramsay sedation scores of group HD
were higher than the other three groups (P<0.01). The extubation time of group HD was longer than the other three groups (P<0.01). The
incidence rates of bradycardia and dry mouth of group MD and HD were increased than group C (P<0.05), and incidence rates of nausea,
vomit and cough were decreased than groupC (P<0.05). The incidence rates of shivering of group MD and HD were decreased than
groupC (P<0.01), and group MD was also decreased than group LD (P<0.05).Conclusion:Intraoperative infusion with 0.5 ug/kg/h
dexmedetomidine could be effective in preventing the postoperative shivering in patients undergoing posterior lumbar interbody fusion. |
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