Kang Xianhui, Tang Xiaodong, Yu Yang, Bao Fangping, Gan Shuyuan, Zheng Wei, Zhang Jian, Zhu Shengmei
Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,
Department of Anesthesiology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China,
Drug Des Devel Ther. 2019 Mar 12;13:871-879. doi: 10.2147/DDDT.S195221. eCollection 2019.
This retrospective cohort study aimed to investigate the association between intraoperative dexmedetomidine infusion and emergence agitation (EA), and recovery profiles after lung surgery in adult patients. It was hypothesized that dexmedetomidine was associated with reduced EA and improved recovery profiles.
A single-center chart review was conducted on elective lung surgeries in adults between January and December 2016. The primary outcome was the incidence of EA in postanesthesia care units (PACUs). The secondary outcomes included rescue analgesia, shivering, time to extubation, residual sedation, postoperative pulmonary events, duration of PACU stay, length of hospital stay, and intraoperative hemodynamic changes. Univariate and multivariate regression analyses were used to analyze data.
Among 2,468 patients, 814 received an intraoperative dexmedetomidine infusion. Intraoperative dexmedetomidine infusion was associated with a lower incidence of EA (10.9% vs 15.0%; adjusted OR, 0.67; 95% CI, 0.51-0.87; =0.003), rescue analgesia (7.6% vs 12.2%; adjusted OR, 0.63; 95% CI, 0.47-0.86; =0.003), shivering (4.2% vs 6.6%; adjusted OR, 0.58; 95% CI, 0.38-0.88; =0.010), and intraoperative bradycardia (18.6% vs 12.6%; adjusted OR, 1.51; 95% CI, 1.19-1.92; =0.001). No differences were observed in residual sedation, duration of PACU stay, postoperative pulmonary events, and length of hospital stay between the groups.
This retrospective study suggested that intraoperative dexmedetomidine infusion was associated with a lower incidence of EA, rescue analgesia, and shivering in adults after lung surgery. Intraoperative bradycardia was the main side effect.
本回顾性队列研究旨在调查成年患者肺手术后术中输注右美托咪定与苏醒期躁动（EA）及恢复情况之间的关联。研究假设右美托咪定与减少EA及改善恢复情况相关。
对2016年1月至12月期间成年患者的择期肺手术进行单中心病历回顾。主要结局是麻醉后监护病房（PACU）中EA的发生率。次要结局包括补救性镇痛、寒战、拔管时间、残余镇静、术后肺部事件、PACU停留时间、住院时间以及术中血流动力学变化。采用单因素和多因素回归分析来分析数据。
在2468例患者中，814例接受了术中右美托咪定输注。术中输注右美托咪定与较低的EA发生率（10.9%对15.0%；校正比值比，0.67；95%可信区间，0.51 - 0.87；P = 0.003）、补救性镇痛（7.6%对12.2%；校正比值比，0.63；95%可信区间，0.47 - 0.86；P = 0.003）、寒战（4.2%对6.6%；校正比值比，0.58；95%可信区间，0.38 - 0.88；P = 0.010）以及术中心动过缓（18.6%对12.6%；校正比值比，1.51；95%可信区间，1.19 - 1.92；P = 0.001）相关。两组之间在残余镇静、PACU停留时间、术后肺部事件及住院时间方面未观察到差异。
这项回顾性研究表明，成年患者肺手术后术中输注右美托咪定与较低的EA、补救性镇痛及寒战发生率相关。术中心动过缓是主要的副作用。
