右美托咪定、地佐辛与曲马多对全麻苏醒恢复质量的影响

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Abstract

ObjectiveTo explore the influence of Dexmedetomidine,Dezocine and Tramadol on postoperative shivering and emergence agitation in patients anesthetized with Sevoflurane undergoing laparoscopic nephrectomy,and haemodynamic stability during extubation.Methods160 patients with kidney cancer in our hospital,American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ,undergoing laparoscopic nephrectomy from January to October in 2016 were selected and divided into the Dexmedetomidine(Dex)group,the Dezocine(Dez)group,the Tramadol(Tra)group,the 0.9%Sodium Chloride Solution(Con)group according to the random number table method,40 cases in each group.All patients were anesthetized with Sevoflurane (≥0.6 MAC)supplemented by Remifentanil 0.15-0.30 μg/(kg·min)after anesthesia induction.The Dex group received 1 mg/kg of Dexmedetomidine,the Dez group received 0.1 mg/kg of Dezocine,the Tra group received 1 mg/kg of Tramadol,the Con group received 0.9%normal saline 30 minutes before the end of surgery.The incidence of postoperative shivering and emergence agitation,the time of autonomous respiration,eye opening,extubation and the mean arterial pressure(MAP),hear rate(HR),Riker Sedation-Agitation Scale and Rameasy sedation score,SpO2were compared at the last three time points and 1,5,10,20,30 min after extubation.ResultsThe incidence of shivering in the three groups of Dex,Dez and Tra were 32.5%,32.5%and 7.5%respectively,which was significantly lower than that of the Con group (57.5%)(P＜0.05),the incidence of shivering in the Tra group was significantly lower than that in the Dex and Dez group (P＜0.05).The incidence of emergence agitation in the Tra,Dez and Dex groups were 40.0%,12.5%and 10.0%,respectively,which was significantly lower than that in the Con group(70.0%)(P＜0.05).The incidence of emergence agitation in the Tra group was significantly higher than that in the Dex and Dez group (P＜0.05).The levels of HR and MAP in the Dex,Dez,and Tra group at T3,T4and T5were significantly lower than those of the Con group (P＜0.05).The level of HR and MBP at T3,T4,and T5in the Con group was significantly higher than that at T1(P＜0.05).The level of HR and MAP at T3and T4in the Dex and Dez group was significantly lower than that in the Tra group (P＜0.05).ConclusionAdministration of Dexmedetomidine (1 μg/kg),Dezocine (0.1 mg/kg)or Tramadol(1 mg/kg)at 30 minutes before the end of surgery can reduces postoperative shivering and emergence agitation,and attenuates the hemodynamic response to extubation in patients receiving Sevoflurane anesthesia for laparoscopic nephrectomy.

Key words： Dexmedetomidine Dezocine Tramadol Shivering Emergence Agitation Hemodynamic changes

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	HAN Ming-jie
	YE Lin-yang

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HAN Ming-jie,YE Lin-yang. Influence of Dexmedetomidine,Dezocine and Tramadol on the general anesthesia recovery quality[J]. 中国当代医药, 2018, 25(2): 104-108.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I2/104

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