Intraoperative dexmedetomidine infusion is associated with reduced emergence agitation and improved recovery profiles after lung surgery: a retrospective cohort study
Intraoperative dexmedetomidine infusion is associated with reduced emergence agitation and improved recovery profiles after lung surgery: a retrospective cohort study
复制标题
术中右美托咪定输注与肺部手术后苏醒期躁动的减少和恢复情况的改善相关：一项回顾性队列研究
DOI：
10.2147/dddt.s195221
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发表时间：
2019-01-01
影响因子：
4.8
通讯作者：
Zhu, Shengmei
中科院分区：
文献类型：
--
作者：
Kang, Xianhui;Tang, Xiaodong;Zhu, Shengmei
目的本回顾性队列研究旨在研究成人患者肺手术后术中右美托咪定输注与苏醒期躁动（EA）和恢复特征之间的相关性。假设右美托咪定与EA减少和恢复特征改善相关。患者和方法2016年1月至12月期间对成人择期肺手术进行了单中心图表审查。主要结局是麻醉后监护室（PACU）中EA的发生率。次要结局包括抢救性镇痛、寒战、拔管时间、残余镇静、术后肺部事件、PACU停留时间、住院时间和术中血流动力学变化。采用单因素和多因素回归分析方法对数据进行分析。结果在2,468例患者中，814例接受了术中右美托咪定输注。术中右美托咪定输注与较低的EA发生率相关（10.9% vs 15.0%;校正OR，0.67; 95% CI，0.51-0.87; P=0.003），补救镇痛（7.6% vs 12.2%;校正OR，0.63; 95% CI，0.47-0.86; P=0.003），寒战（4.2% vs 6.6%;校正OR，0.58; 95% CI，0.38-0.88; P=0.010）和术中心动过缓（18.6% vs 12.6%;校正OR，1.51; 95% CI，1.19-1.92; P=0.001）。两组之间在残余镇静、PACU停留时间、术后肺部事件和住院时间方面没有观察到差异。结论这项回顾性研究表明，术中右美托咪定输注与成人肺手术后EA、急救镇痛和寒战的发生率较低相关。术中心动过缓是主要副作用。
Purpose 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. Patients and methods 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. Results 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; P=0.003), rescue analgesia (7.6% vs 12.2%; adjusted OR, 0.63; 95% CI, 0.47–0.86; P=0.003), shivering (4.2% vs 6.6%; adjusted OR, 0.58; 95% CI, 0.38–0.88; P=0.010), and intraoperative bradycardia (18.6% vs 12.6%; adjusted OR, 1.51; 95% CI, 1.19–1.92; P=0.001). No differences were observed in residual sedation, duration of PACU stay, postoperative pulmonary events, and length of hospital stay between the groups. Conclusion 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.