标题：右美托咪啶与氟芬合剂防治阑尾牵拉反射的比较

      作者：丁登峰，陶明哲，李亚丽，陈丽瑜，张丽媛，郑春丽
    （暨南大学第二临床医学院附属深圳市人民医院麻醉科，广东 深圳 518020）

      卷次： 2013年24卷7期

      【摘要】 目的 比较右美托咪啶与氟芬合剂防治阑尾牵拉反射的效果。方法 选择ASAⅠ~Ⅱ级的急性阑
尾炎患者60例，随机分为两组，右美组静脉输注负荷量右美托咪啶1 ?g/kg，继以1 ?g·kg-1·h-1维持，氟芬组静脉
输注负荷量芬太尼1 ?g/kg和氟哌利多50 ?g/kg，继以芬太尼1 ?g·kg-1·h-1和氟哌利多50 ?g·kg-1·h-1维持，观察麻
醉前（T1）、硬膜外穿刺前（T2）、硬膜外麻醉起效后(T3)、牵拉阑尾时(T4)、手术结束时（T5）的血压心率及防治牵拉反
射的效果，静脉输注后即刻、15 min、30 min、45 min的改良OAA/S评分，术中恶心、呕吐、寒战、低血压、心动过缓的
发生情况。结果 两组血压心率T3、T4、T5时点显著低于T1、T2 (P<0.05)，与氟芬组比较，右美组改良OAA/S评分和
寒战发生率低，防治牵拉反射效果好。结论 与氟芬合剂相比，右美托咪啶防治阑尾牵拉反射效果好，镇静作用
强，可抑制寒战。

      【关键词】 右美托咪啶；氟芬合剂；阑尾炎；手术；牵拉反射

      【中图分类号】 R656.8 【文献标识码】 A 【文章编号】 1003—6350（2013）07—0967—03


Comparative study on the effect of dexmedetomidine and Innovar in preventing and curing stretch reflex in
appendectomy.
DING Deng-feng, TAO Ming-zhe, LI Ya-li, CHEN Li-yu, ZHANG Li-yuan, ZHENG Chun-li.
Department of Anesthesiology, Shenzhen People's Hospital Affiliated to the Second Clinical Medical College of Jinan
University, Shenzhen 518020, Guangdong, CHINA

【Abstract】 Objective To compare the effect of dexmedetomidine and Innovar in preventing and curing
stretch reflex in appendectomy. Methods Sixty patients with ASA physical statusⅠ andⅡ scheduled for appendec-
tomy were randomly allocated into two groups. The dexmedetomidine group received 1 ?g/kg of dexmedetomidine,
followed by 1 ?g·kg-1·h-1 continuous infusion. The Innovar group received 1 ?g/kg of fentanyl and 50 ?g/kg of dro-
peridol, followed by 1 ?g·kg-1·h-1 of fentanyl and 50 ?g·kg-1·h-1 of droperidol. Blood pressure, heart rate, effect of
preventing and curing the stretch reflex were detected before anesthesia (T1), before epidural puncture (T2), after the
onset of epidural anesthesia (T3), at stretch reflex (T4), and at the end of surgery (T5). Modified OAA/S scale after intra-
venous injection, incidence of nausea, vomiting, shivering, hypotension, bradycardia during operation were deter-
mined immediately, 15 min, 30 min, 45 min after intravenous infusion. Results Blood pressure and heart rate were
decreased obviously in the two groups at T3, T4, T5 than T1, T2 (P<0.05). The modified OAA/S scale and incidence of
shivering were significantly lower and the effect of preventing and curing stretch reflex was significantly better in dex-
medetomidine group, compared with the Innovar group. Conclusion Dexmedetomidine has better effect in prevent-
ing and curing stretch reflex and sedation than Innovar, which can suppress shivering.