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崔凌利, 邹毅, 张梁, 等. 右美托咪定对腹腔镜供肝获取术供者苏醒期恢复质量的影响[J]. koko体育app 学报(医学版), 2024, 55(3): 693-698. DOI:
引用本文: 崔凌利, 邹毅, 张梁, 等. 右美托咪定对腹腔镜供肝获取术供者苏醒期恢复质量的影响[J]. koko体育app 学报(医学版), 2024, 55(3): 693-698. DOI:
CUI Lingli, ZOU Yi, ZHANG Liang, et al. Effects of Dexmedetomidine on the Recovery Quality of Donors Undergoing Pure Laparoscopic Donor Hepatectomy[J]. Journal of Sichuan University (Medical Sciences), 2024, 55(3): 693-698. DOI:
Citation: CUI Lingli, ZOU Yi, ZHANG Liang, et al. Effects of Dexmedetomidine on the Recovery Quality of Donors Undergoing Pure Laparoscopic Donor Hepatectomy[J]. Journal of Sichuan University (Medical Sciences), 2024, 55(3): 693-698. DOI: 🐼

右美托咪定对腹腔镜供肝获取术供者苏醒期恢复质量的影响

Effects of Dexmedetomidine on the Recovery Quality of Donors Undergoing Pure Laparoscopic Donor Hepatectomy

  • 摘要:
    目的 观察术中输注右美托咪定(dexmedetomidine, DEX)对行活体肝移植腹腔镜供肝获取术供者术后苏醒质量的影响。
    方法 前瞻性纳入择期行活体肝移植腹腔镜供肝切取术供肝脏者56例,随机分为两组(n=28):DEX组和对照组。DEX组患者入室后静脉泵注DEX 1 μg/kg 15 min,随后以0.4 μg/(kg·h)输注至供肝肝门静脉阻断后停止;对照组患者采用等容积0.9%生理盐水,输注速度和停药时间同DEX组。主要观察指标为苏醒期躁动(emergence agitation, EA)的发生率,苏醒期躁动依据AFPS(Aono's four-point scale)评分进行评估。次要观察指标包括术中麻醉和手术情况、术后自主呼吸恢复时间、苏醒时间、拔管时间、Ramsay镇静评分、寒战发生率、数字评分法(numeric rating scale, NRS)疼痛评分、拔管期血压以及心率等。
    结果 DEX组和对照组术后苏醒期躁动发生率分别为10.7%和39.3%,DEX组躁动发生率低于对照组(P=0.014)。DEX组供者APFS躁动评分〔中位数(四分位间距)〕较对照组更低〔1(1,1)分vs. 2(1,3)分,P=0.005〕。DEX组术中丙泊酚和瑞芬太尼的用量明显减少(P<0.05),DEX组苏醒期需追加镇痛的人数更少,血压和心率更低(P<0.05)。两组供体术后自主呼吸恢复时间、苏醒时间、拔管时间、寒战发生率、Ramsay评分、NRS评分、麻醉后监测治疗室(postanesthesia care unit, PACU)停留时间差异无统计学意义(P>0.05)。
    结论 DEX能够降低活体肝移植供者苏醒期躁动发生率,改善苏醒期恢复质量,且不影响术后苏醒和拔管时间。
     
    Abstract:
    Objective To investigate the effects of intraoperative intravenous administration of dexmedetomidine (DEX) on the recovery quality of donors undergoing pure laparoscopic donor hepatectomy.
    Methods A total of 56 liver donors who were going to undergo scheduled pure laparoscopic donor hepatectomy were enrolled and randomly assigned to two groups, a DEX group (n=28) and a control group (n=28). Donors in the DEX group received DEX infusion at a dose of 1 μg/kg over 15 minutes through a continuous pump, which was followed by DEX at 0.4 μg/(kg·h) until the disconnection of the portal branch. Donors in the control group were given an equal volume of 0.9% normal saline at the same infusion rate and over the same period of time as those of the dex infusion in the DEX group. The primary outcome was the incidence of emergence agitation (EA). The Aono's Four-point Scale (AFPS) score was used to assess EA. The secondary observation indicators included intraoperative anesthesia and surgery conditions, spontaneous respiration recovery time, recovery time, extubation time, scores for the Ramsay Sedation Scale, the incidence of chills, numeric rating scale (NRS) score for pain, and blood pressure and heart rate after extubation.
    Results The incidence of EA was 10.7% and 39.3% in the DEX group and the control group, respectively, and the incidence of EA was significantly lower in the DEX group than that in the control group (P=0.014). The APFS scores after extubation in the DEX group were lower than those in the control group (1 1, 1 vs. 2 1, 3, P=0.005). Compared to the control group, the dosages of intraoperative propofol and remifentanil were significantly reduced in the DEX group (P<0.05). During the recovery period, the number of donors requiring additional boluses of analgesia, the blood pressure, and the heart rate were all lower in the DEX group than those in the control group (P<0.05). No significant differences between the two groups were observed in the spontaneous respiration recovery time, recovery time, extubation time, the incidence of chills, NRS score, scores for the Ramsay Sedation Scale, and the length-of-stay in postanesthesia care unit (PACU) (P>0.05).
    Conclusion DEX can reduce the incidence of EA after pure laparoscopic donor hepatectomy and improve the quality of recovery without prolonging postoperative recovery time or extubation time.
     

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