摘要
目的探讨利多卡因联合右美托咪定对甲状腺手术患者术后恶心呕吐的改善效果。方法选取128例行甲状腺手术患者,随机分为A、B、C、D四组,A组单用利多卡因,B组单用右美托咪定,C组联合利多卡因+右美托咪定,D组用等容量的生理盐水,对比四组患者血流动力学指标、术后PONV及围术期不良事件。结果与D组相比,其余三组的血流动力学指标变化明显减小,且C组尤为突出(P<0.05);术后0-6h恶心发生率对比,D组>A组>B组>C组,C组在术后0-12h内的恶心与呕吐发生率、术后12-24h恶心发生率均较A、B、D组低(P<0.05),术后12-24h的呕吐发生率与A、B组无差异(P>0.05),与D组有明显差异(P<0.05);术后24h内PONV程度评分,D组>A、B组>C组(P<0.05);围术期不良事件发生率对比,C组低血压、窦缓发生率比A、B、D组高(P<0.05)。结论联合利多卡因联合右美托咪定可减少血流动力学的影响,改善甲状腺手术患者PONV情况,但可能会增加围术期不良事件发生率。
Objective To investigate the effect of lidocaine combined with dexmedetomidine on postoperative nausea and vomiting in patients undergoing thyroid surgery.Methods 128 patients undergoing thyroid surgery were randomly divided into four groups:A,B,C and D.Group A was treated with lidocaine alone,group B was treated with dexmedetomidine alone,group C was combined with lidocaine+dexmedetomidine,and group D was treated with equal volume of normal saline.The hemodynamic indexes,postoperative PONV and perioperative adverse events of the four groups were compared.Results Compared with group D,the changes of hemodynamic indexes in the other three groups were significantly reduced,especially in group C(P<0.05);The incidence of nausea at 0-6h after operation in group D>group A>group B>group C.The incidence of nausea and vomiting at 0-12h and 12-24h after operation in group C were lower than those in groups A,B and D(P<0.05).The incidence of vomiting at 12-24h after operation was not different from that in groups A and B(P>0.05),but significantly different from that in group D(P<0.05);The PONV score in group D>group A,group B>group C within 24 hours after operation(P<0.05);The incidence of perioperative adverse events in group C was higher than that in groups A,B and D(P<0.05).Conclusion Lidocaine combined with dexmedetomidine can reduce the impact of hemodynamics and improve PONV in patients undergoing thyroid surgery,but it may increase the incidence of perioperative adverse events.
作者
罗芬
吴智国
LUO Fen;WU Zhiguo(Department of Anesthesiology,the fourth division hospital of Xinjiang production and Construction Corps,Yining,Xinjiang,835000,China)
出处
《新疆医学》
2024年第8期967-971,共5页
Xinjiang Medical Journal
关键词
甲状腺手术
利多卡因
右美托咪定
术后恶心呕吐
thyroid surgery
Lidocaine
Dexmedetomidine
Postoperative nausea and vomiting
