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论著:右旋美托嘧啶对术中镇静药量和术后谵妄的影响
Impact of Dexmedetomidine on Intraoperative Sedative Consumption and Postoperative Delirium
沈健 陈家伟 尹华 朱敏敏 谭志明
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作者单位:复旦大学附属肿瘤医院麻醉科
中文关键字:右旋美托嘧啶;术后谵妄;丙泊酚
英文关键字:Dexmedetomidine; Postoperative delirium; Propofol
中文摘要:目的:探讨右旋美托嘧啶(dexmedetomidine, DEX)对术中镇静药用量和术后谵妄的影响。方法:全麻下行结直肠癌根治术的患者80例随机分为2组:(1)DEX组(D组,n=40)术前10 min内静脉输注右旋美托嘧啶0.7 μg/kg并以0.4 μg/(kg·h)持续输注至术毕;(2)对照组(C组,n=40)以0.9%氯化钠液代替DEX,用法、用量与D组相同。观察记录2组患者的心率、血压、脉搏氧饱和度、状态熵、术中丙泊酚用量、术后谵妄分级量表评分和Ramsay镇静评分。结果:D组患者丙泊酚用量比C组患者显著减少(P<0.05),D组患者术后谵妄分级量表评分和Ramsay镇静评分均比C组患者显著降低(P<0.05)。结论:DEX可减少术中丙泊酚用量,减少术后谵妄的发生率。
英文摘要:Objective: To observe the beneficial effects of dexmedetomidine on intraoperative propofol consumption and the incidence of postoperative delirium in patients receiving general anesthesia. Methods: A total of 80 patients (ASA Class I~II) scheduled to receive colorectal cancer surgery under general anesthesia were randomly divided into 2 groups: dexmedetomidine group(Group D) or control group(Group C). Group D: patients were given a loading dosage of dexmedetomidine(0.7 μg/kg) intravenously 10mins before the induction of general anesthesia followed by continuous infusion(0.4 μg/kg·h). Goup C: patients were given 0.9% saline solution instead of dexmedetomidine. Intraoperative propofol consumption, delirium rating scale and Ramsay sedation score were documented. Results: Compared with patients in Group C, patients in Group D had lower delirium rating scale and Ramsay sedation score and propofol consumption(P<0.05). Conclusions: Dexmedetomidine may decrease intraoperative sedative consumption and prevent postoperative delirium in patients receiving general anesthesia.
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