右美托咪啶对宫外孕腹腔镜术后寒战的影响.pdf

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1、第23卷第5期江苏大学学报(医学版)Vo1．23No．52013年9月JournalofJiangsuUniversity(MedicineEdition)Sept．2013右美托咪啶对宫外孕腹腔镜术后寒战的影响刘剑锋，马凤亚，蒋平(江苏大学附属武进医院麻醉科，江苏常州213002)[摘要]目的：评价右美托咪啶(dexmedetomidine，DEX)对腹腔镜宫外孕术后寒战的影响。方法：全麻下行腹腔镜宫外孕手术患者120例，ASA分级I或Ⅱ级，将患者随机分为4组(n=30)：生理盐水对照组、右美托咪啶组、输血对照组(输血组)和输血右美托咪啶组(输血DEX组

2、)。4组的麻醉诱导及维持方法相同，术中维持BIS值40～55。右美托咪啶组开放静脉后静脉输注右美托咪啶0．5g·(kg·h)。。至手术结束前0．5h；生理盐水组静脉输注等容量生理盐水；输血DEX组(术中出血大于800mL酌情输注血液)开放静脉后静脉输注右美托咪啶0．5g·(kg·h)至手术结束前0．5h；输血组(术中出血大于800mL酌情输注血液)静脉输注等容量生理盐水；记录术后1h内寒战发生情况。结果：生理盐水组、右美托咪啶组、输血组、输血DEX组寒战发生率分别为50％(15例)、10％(3例)、57％(17例)和20％(6例)。与生理盐水组比较，右美托

3、咪啶组寒战发生率降低，寒战程度减轻(P<0．05)；与输血组比较，输血DEX组寒战发生率降低，寒战程度减轻(P<0．05)。结论：右美托咪啶辅助麻醉可降低宫外孕患者麻醉后寒战的发生概率。[关键词]右美托咪啶；寒战；麻醉；手术后并发症[中图分类号]R614．24[文献标志码]A[文章编号]】671—7783(2013)05—0428—04EffectofdexmedetomidineonshiveringafterlaparoscopicsurgeryofectopicpregnancyLIUJianng，MAFeng—ya．JIANGPtngtheAffi

4、liatedwnjinHospitalofJiangsuUniversity，ChangzhouJiangsu213002，China)[Abstract]objective：Toevaluatetheeffectsofdexmedetomidineonshiveringafterlaparoscopiesurgeryofectopicpregnancy．Methods：Atotalof120casesASAIorIIpatientsintheoperationundergeneralan—esthesiainlaparoscopyforectopicpr

5、egnancywererandomlydividedinto4groups(n=30each)：normalsa—linecontrolgroup(groupN)，dexmedetomidinegroup(groupD)andbloodtransfusioncontrolgroup(groupBb)，bloodtransfusiondexmedetomidinegroup(groupBd)．Fourgroupsusingthesameanesthesiainductionandmaintenancemethods．BISwasmaintainedat40—

6、55duringsurgery．GroupDreceiveddexmedetomi—dineintravenousinfusionat0．5[xg·(kg·h)～fromimmediatelyafteropenthevineuntil0．5hbeforetheendofoperation，groupNreceivedtheequalvolumeofnormalsaline．GroupBd(whentheamountofbloodlossgreaterthan800mLinfusionofblood)receiveddexmedetomidineintrav

7、enousinfusionat0．5g·(kg·h)一fromimmediatelyafteropeningtheveinuntil0．5hbeforetheendofoperationandgroupBb(whentheamountofbloodlossgreaterthan800mLinfusionofblood)receivedtheequalvolumeofnormalsaline．Theshiveringwithin1hafteroperationwasscoredandrecorded．Results：Theincidencerateofpos

8、tanes—theticshiveringwas50％ingrou