上海针灸杂志2019，Vol.38Issue(2)：198-201,4.DOI:10.13460/j.issn.1005-0957.2019.02.0198
针药复合麻醉应用右美托咪定对甲状腺切除术后呕吐的影响
Influence of Dexmedetomidine Applied in Combined Acupuncture-medication Anesthesia on Vomiting After Thyroidectomy
摘要
Abstract
Objective To observe the influence of dexmedetomidine applied in combined acupuncture-medication anesthesia on vomiting after thyroidectomy. Method Seventy patients who were going to receive thyroidectomy were randomized into group A and B, with 35 cases in each group. Combined acupuncture-medication anesthesia [electroacupuncture at Hegu (LI4), Neiguan (PC6) and Futu (ST32) plus intravenous infusions of sufentanil citrate injection (0.3 mg/kg) 20 minutes before operation]was adopted in both groups. Group A was additionally intervened by constantvelocity micropump infusion of dexmedetomidine hydrochloride injection (0.5 mg/kg) within 10 minutes before operation and remaining 0.4 mg/kg/min during operation, while group B was intervened by infusion of normal saline 10 minutes before operation. The observer's assessment of awareness/sedation (OAA/S) scores at different time points[lying in bed for 5 minutes before operation (T0), before the beginning of the operation (T1), 30 minutes after operation (T2), 60 minutes after operation (T3) and at the end of operation (T4)] in the two groups were observed. The additional times and total dose of sufentanil during operation, the number of cases using esmolol and urapidil, and the number of vomiting cases occurred within 2 hours after operation and 2～24 hours after operation in the two groups were recorded.Result The additional times and total dose of sufentanil during operation in group A were significantly different from those in group B (P<0.01). The utilization rate of esmolol and urapidil were respectively 31.4％ and 14.3％ in group A versus 77.1％ and 65.7％ in group B, and the between-group differences were statistically significant (P<0.01). The incidence of vomiting within 2 hours after operation and 2～24 hours after operation were respectively 20.0％ and 17.1％in group A versus 54.3％ and 42.9％ in group B, and the between-group differences were statistically significant (P<0.01). The OAA/S scores at different time points (T1, T2, T3 and T4) in group A were significantly different from those in group B (P<0.01). Conclusion Dexmedetomidine applied in combined acupuncture-medication anesthesia can reduce the additional times and total dose of sufentanil during thyroidectomy, and it can reduce the incidence of postoperative vomiting as well.关键词
针刺疗法/电针/针刺麻醉/手术后恶心和呕吐/针药复合麻醉/甲状腺切除术/右美托咪定/舒芬太尼Key words
Acupuncture therapy/Electroacupuncture/Acupuncture anesthesia/Postoperative nausea and vomiting/Combined acupuncture medication anesthesia/Thyroidectomy/Dexmedetomidine/Sufentanil分类
医药卫生引用本文复制引用
李连红,王永强,傅国强,袁岚,葛茂军..针药复合麻醉应用右美托咪定对甲状腺切除术后呕吐的影响[J].上海针灸杂志,2019,38(2):198-201,4.基金项目
上海中医药发展三年行动计划高层次中西医结合人才培养项目 （）
上海市教育委员会科技创新项目(2012JW44) （2012JW44）
上海市科委自然科学基金项目(16ZR1437900) （16ZR1437900）
