Department of Anesthesiology, Affiliated Hospital of Weifang Medical University, Weifang, 261000, China.
School of Anesthesiology, Weifang Medical University, Weifang, 261000, China.
Aging Clin Exp Res. 2022 Mar;34(3):611-618. doi: 10.1007/s40520-021-01984-y. Epub 2021 Sep 22.
To clarify the effect of an intraoperative low-dose dexmedetomidine infusion on emergence agitation following general anaesthesia in elderly patients.
Eighty elderly patients (> 64-years-old) following elective general anaesthesia for radical cancer surgeries were randomly allocated into two groups (n = 40 each): the dexmedetomidine group (Group D) and the normal saline group (Group C). Anaesthesia was maintained with continuous intravenous infusion of dexmedetomidine at - 0.2 µg kg h in Group D, and an equal volume of normal saline (0.5 ml kg h) was given in Group C. All patients were observed for 30 min in the post-anaesthesia care unit (PACU), AFPS and NRS were recorded every 2 min, and the total doses of nalbuphine and fentanyl were calculated in the PACU. MAP and HR were recorded at the time of 10 min (T1), 20 min (T2), 30 min (T3) after dexmedetomidine or saline pumping, and before extubation (T4), immediately after extubation (T5), and 5 min after extubation (T6). We also documented some durations, including anaesthesia duration (D1), surgery duration (D2), duration from the end of surgery to extubation (D3), and emergence agitation duration (D4).
The MAP in Group C was significantly higher than that in Group D (P < 0.05), and there were no significant changes between the two groups in HR and MAP within each time point and D1, D2, D3, and D4. The incidence of agitation, NRS score and total dose of nalbuphine and fentanyl were all lower in Group D than in Group C (P < 0.05).
An intraoperative low-dose dexmedetomidine continuous infusion can reduce emergence agitation following general anaesthesia in elderly patients (> 64-years-old), remain stable in terms of haemodynamics, and not lead to delays in anaesthesia recovery time and extubation time.
阐明术中低剂量右美托咪定输注对老年患者全麻苏醒期躁动的影响。
选择 80 例行择期全麻根治性癌症手术的老年患者（年龄>64 岁），随机分为两组（每组 40 例）：右美托咪定组（D 组）和生理盐水组（C 组）。D 组麻醉维持时持续静脉输注右美托咪定-0.2μg·kg-1·h-1，C 组给予等容量生理盐水（0.5ml·kg-1·h-1）。所有患者均在麻醉后监护室（PACU）观察 30min，每 2min 记录一次镇静躁动评分（AFPS）和数字疼痛评分（NRS），并计算 PACU 中纳布啡和芬太尼的总剂量。记录 T1（右美托咪定或生理盐水输注后 10min）、T2（20min）、T3（30min）时的 MAP 和 HR，以及 T4（拔管前）、T5（拔管即刻）和 T6（拔管后 5min）的 MAP 和 HR。记录麻醉时间（D1）、手术时间（D2）、手术结束至拔管时间（D3）和苏醒期躁动时间（D4）等。
C 组 MAP 明显高于 D 组（P<0.05），两组各时间点及 D1、D2、D3、D4 时 HR 和 MAP 均无显著变化。D 组躁动发生率、NRS 评分和纳布啡、芬太尼总剂量均低于 C 组（P<0.05）。
术中持续低剂量右美托咪定输注可减少老年患者（>64 岁）全麻苏醒期躁动，对血流动力学稳定，不延长麻醉恢复时间和拔管时间。
