目的 探讨右美托咪定减少神经外科手术患者麻醉苏醒期躁动(EA)的效果及安全性.方法 选择我院2008年2月~2012年2月行全麻神经外科手术患者200例,将其随机分为观察组和对照组,各100例,两组麻醉诱导用药及术中处理相同,其中观察组围麻醉期应用右美托眯定.观察两组手术时间,记录不同时点心率、血压、血氧饱和度(SpO2)及手术结束后首次自主呼吸出现时间、气管导管拔除时间、苏醒期躁动评级、遗忘程度评级.结果 两组吸痰时、拔管时和拔管后5 min血压、心率比较,差异有统计学意义(P<0.05).观察组躁动率、遗忘率与对照组比较,差异有统计学意义(P<0.05),而呼吸恢复时间、唤醒时间和拔管时间等方面比较差异无统计学意义(P>0.05).结论 右美托咪定可减少神经外科手术患者EA发生,且对呼吸、循环功能无明显抑制作用,其苏醒快且生命体征稳定,为较理想的麻醉复合用药.%Objective To investigate the effect and safety of Dexmedetomidine in reducing anesthesia emergence agitation (EA) of surgical patients in neurosurgery department. Methods 200 cases of patients with neurosurgery surgery under general anesthesia in our hospital from February 2008 to February 2012 were selected and all patients were randomly divided into observation group and control group, with 100 cases in each group. Two groups were all given the same anesthesia induction medication and surgery dealing. The operative time, record heait rate, blood pressure, SpO2 in different time points, and the first own breathing time after surgery, tracheal extubation time, emergence agitation dysphoria grade, and forgotten degree were observed. Results There were significant differences of blood pressure, heart, rate of the two groups at the moment of phlegm sucking, exiubation and 5 min after extnbation (P ＜ 0.05). The agitation rate, forgetting rate of observation group was significantly different from the control group (P ＜ 0.05 ). Absorption recovery time, wake time and extubation lime of two groups were compared, there was no significant difference (P ＞ 0.05). Conclusion Dexmedetomidine can certainly reduce the EA of neurosurgical patients, and ii has no significani inhibitory effect on the respiratory, circulatory function, the patients wake quickly and vital signs is stable, so it is an ideal anesthetic compound medication.
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