杨明敏 张奇芬 吴少勇 陶晓三

[摘要] 目的 观察盐酸达克罗宁胶浆对七氟烷全身麻醉患者苏醒期血流动力学和苏醒质量的影响。 方法 随机选择2013年1月～2014年12月至我院进行全身麻醉手术的患者100例，使用随机数字表法将患者分为观察组和对照组，各50例。对照组使用七氟烷进行常规麻醉，观察组在气管导管球囊表面均匀涂抹盐酸达克罗宁胶浆，其余麻醉方式同对照组。观察两组患者麻醉诱导前、拔管前1 min、拔管后3 min的收缩压（SBP）、舒张压（DBP）、心率（HR）情况。观察两组患者拔管后发生屏气、呛咳、躁动的比例。 结果 两组患者麻醉诱导前、拔管前1 min的SBP、DBP、HR差异均无统计学意义（P>0.05），拔管后3 min，观察组患者的上述指标明显低于对照组，差异有统计学意义（P<0.05）。对照组患者拔管后3 min的SBP、DBP、HR明显高于同组麻醉诱导前，差异有统计学意义（P<0.05），观察组患者拔管后3 min的SBP、DBP、HR与同组麻醉诱导前差异无统计学意义（P>0.05）。观察组发生屏气、呛咳、躁动的比例明显低于对照组，差异有统计学意义（P<0.05）。 结论 盐酸达克罗宁胶浆具有较好的改善全身麻醉患者苏醒期血流动力学和苏醒质量的作用。

[关键词] 盐酸达克罗宁胶浆；七氟烷；全身麻醉；苏醒质量；血流动力学

[中图分类号] R614.2 [文献标识码] A [文章编号] 1674-4721（2016）03（b）-0132-03

[Abstract] Objective To observe the influence of dyclonine hydrochloride mucilagines on hemodynamics and awakening quality for patients with general anesthesia using sevoflurane during awakening period. Methods 100 patients given general anesthesia operation in our hospital from January 2013 to December 2014 were randomly selected and they were divided into observation group （n=50） and control group （n=50） according to the random number table method.Control group was given the routine sevoflurane general anesthesia while observation group was evenly applied dyclonine hydrochloride mucilagines in the endotracheal tube balloon surface，the rest of the anesthesia method was similar with control group.Systolic blood pressure （SBP），diastolic blood pressures （DBP），heart rate （HR） before anesthesia induction，before 1 min extubation and after 3 min extubation in patients of two groups was observed respectively.The proportion of breathless，choking cough，agitation after extubation of patients in two groups was observed respectively. Results There was no statistical difference of SBP，DBP，HR before anesthesia induction，before 1 min extubation in patients between two groups （P>0.05）.After 3 min extubation，the above-mentioned indexes of observation group was significantly lower than that of control group，the difference was significant statistically significant （P<0.05）.SBP，DBP，HR of control group after 3 min extubation was significantly higher than that before anesthesia induction，the difference was significant statistically significant （P<0.05）.There was no statistical difference of SBP，DBP，HR in observation group after 3 min extubation compared with before anesthesia induction （P>0.05）.The proportion of breathless，choking cough，agitation of observation group was significantly lower than that of control group，the difference was significant statistically significant （P<0.05）. Conclusion The dyclonine hydrochloride mucilagines has better effect for improving the hemodynamics and awakening quality in patients with general anesthesia during awakening period.

[Key words] Dyclonine hydrochloride mucilagines；Sevoflurane；General anesthesia；Awakening quality；Hemodynamics

七氟烷复合丙泊酚是目前临床上常用的全身麻醉用药，其血液中溶解度相对较低， 在麻醉诱导时具有肺泡药物浓度快速上升而停止吸入后又快速下降的特点，因此可迅速诱导又不会导致心率失常，且七氟烷复合丙泊酚具有极轻微的压力感受反射作用，对血流动力学影响小，适用于合并心脑血管疾病及老年患者的麻醉，但是麻醉的副作用往往会导致苏醒期患者血流动力学异常，影响其苏醒质量[1-2]。为了解决这一问题，我院近年来在患者全身麻醉过程中使用盐酸达克罗宁（dyclonine），取得了良好疗效。