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目的研究右美托咪啶复合局部麻醉在喉癌切除术前气管造口术中的应用。方法选择2009年1月-2011年12月将要施行全喉切除或喉部分切除+喉功能重建术的40例喉癌患者,随机分为局部麻醉对照组(对照组)和右美托咪啶复合局部麻醉组(研究组),每组20例。观察两组气管切开术前、术中及术后平均动脉压(MAP)、心率、血氧饱和度(Sp O2),术中采用Ramsay镇静评分观察患者镇静情况,以评分在2~4分为优。结果与对照组比较,术中研究组较患者MAP、心率稳定,组间差异有统计学意义(P<0.05);Sp O2均无明显波动,组间差异无统计学意义(P>0.05),但呛咳、屏气、挣扎发生率明显降低,麻醉效果更满意(P<0.05)。结论右美托咪啶复合局部麻醉较单纯局部麻醉能更好地满足喉癌切除术前气管造口术的要求,增加患者舒适度,且无不良反应。
Objective To study the application of dexmedetomidine combined with local anesthesia in tracheostomy before laryngectomy. Methods Forty patients with laryngeal carcinoma who underwent total laryngectomy or partial laryngectomy plus laryngeal functional reconstruction from January 2009 to December 2011 were randomly divided into local anesthesia control group (control group) and dexmedetomidine Local anesthesia group (study group), 20 cases in each group. The mean arterial pressure (MAP), heart rate and oxygen saturation (Sp O2) before, during and after tracheotomy were observed in both groups. The sedation of patients was observed by Ramsay sedation score in 2 to 4 Excellent. Results Compared with the control group, MAP and heart rate in the study group were significantly higher than those in the control group (P <0.05). There was no significant difference in Sp O2 between the two groups (P> 0.05) However, cough, breath holding, the incidence of struggles was significantly reduced, and the anesthetic effect was more satisfactory (P <0.05). Conclusion Dexmedetomidine combined with local anesthesia can better meet the needs of tracheostomy before laryngectomy than local anesthesia, increase patient comfort, and no adverse reactions.