中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2011年
1期
44-46
,共3页
张红斌%王公明%孙连功%唐贞申%张孟元
張紅斌%王公明%孫連功%唐貞申%張孟元
장홍빈%왕공명%손련공%당정신%장맹원
右美托咪啶%舒芬太尼%高血压%镇痛,病人控制
右美託咪啶%舒芬太尼%高血壓%鎮痛,病人控製
우미탁미정%서분태니%고혈압%진통,병인공제
Dexmedetomidine%Sufentanil%Hypertension%Analgesia,patient-controlled
目的 探讨右美托咪啶对原发性高血压病人术后舒芬太尼自控静脉镇痛效果的影响.方法 择期拟行经腹子宫全切术的原发性高血压病人60例,年龄42～63岁,体重48～72 kG,高血压分级Ⅰ或Ⅱ级,ASA分级Ⅱ或Ⅲ级,采用随机数字表法,将病人随机分为3组(n=20):对照组(C组)、不同剂量右美托咪啶组(D1组和D2组).术后24 h内行舒芬太尼PCIA,舒芬太尼100μg+托烷司琼5 mg+生理盐水100ml,背景输注速率2 ml/h,PCIA剂量0.5ml,锁定时间15 min.D1组和D2组在PCIA同时分别以0.2和0.3μg·kg-1·h-1的速率静脉输注右美托咪啶,C组在PCIA同时以0.1 ml·kg-1 的速率静脉输注生理盐水.术后24h内记录总按压次数、舒芬太尼用量和硝苯地平、麻黄碱的使用情况及呼吸抑制和呕吐的发生情况,术后24h时行Ramsay镇静评分.结果 与C组比较,D1组和D2组PCIA总按压次数减少,舒芬太尼用量降低,Ramsay镇静评分升高,硝苯地平使用率、呼吸抑制和呕吐发生率降低,D2组麻黄碱使用率升高(P＜0.05);与D1组比较,D2组PCIA总按压次数减少,舒芬太尼用量降低,Ramsay镇静评分升高,麻黄碱使用率升高(P＜0.05).结论 右美托咪啶不仅可减少原发性高血压病人术后舒芬太尼PCIA的用量,还可预防术后高血压进一步恶化.
目的 探討右美託咪啶對原髮性高血壓病人術後舒芬太尼自控靜脈鎮痛效果的影響.方法 擇期擬行經腹子宮全切術的原髮性高血壓病人60例,年齡42～63歲,體重48～72 kG,高血壓分級Ⅰ或Ⅱ級,ASA分級Ⅱ或Ⅲ級,採用隨機數字錶法,將病人隨機分為3組(n=20):對照組(C組)、不同劑量右美託咪啶組(D1組和D2組).術後24 h內行舒芬太尼PCIA,舒芬太尼100μg+託烷司瓊5 mg+生理鹽水100ml,揹景輸註速率2 ml/h,PCIA劑量0.5ml,鎖定時間15 min.D1組和D2組在PCIA同時分彆以0.2和0.3μg·kg-1·h-1的速率靜脈輸註右美託咪啶,C組在PCIA同時以0.1 ml·kg-1 的速率靜脈輸註生理鹽水.術後24h內記錄總按壓次數、舒芬太尼用量和硝苯地平、痳黃堿的使用情況及呼吸抑製和嘔吐的髮生情況,術後24h時行Ramsay鎮靜評分.結果 與C組比較,D1組和D2組PCIA總按壓次數減少,舒芬太尼用量降低,Ramsay鎮靜評分升高,硝苯地平使用率、呼吸抑製和嘔吐髮生率降低,D2組痳黃堿使用率升高(P＜0.05);與D1組比較,D2組PCIA總按壓次數減少,舒芬太尼用量降低,Ramsay鎮靜評分升高,痳黃堿使用率升高(P＜0.05).結論 右美託咪啶不僅可減少原髮性高血壓病人術後舒芬太尼PCIA的用量,還可預防術後高血壓進一步噁化.
목적 탐토우미탁미정대원발성고혈압병인술후서분태니자공정맥진통효과적영향.방법 택기의행경복자궁전절술적원발성고혈압병인60례,년령42～63세,체중48～72 kG,고혈압분급Ⅰ혹Ⅱ급,ASA분급Ⅱ혹Ⅲ급,채용수궤수자표법,장병인수궤분위3조(n=20):대조조(C조)、불동제량우미탁미정조(D1조화D2조).술후24 h내행서분태니PCIA,서분태니100μg+탁완사경5 mg+생리염수100ml,배경수주속솔2 ml/h,PCIA제량0.5ml,쇄정시간15 min.D1조화D2조재PCIA동시분별이0.2화0.3μg·kg-1·h-1적속솔정맥수주우미탁미정,C조재PCIA동시이0.1 ml·kg-1 적속솔정맥수주생리염수.술후24h내기록총안압차수、서분태니용량화초분지평、마황감적사용정황급호흡억제화구토적발생정황,술후24h시행Ramsay진정평분.결과 여C조비교,D1조화D2조PCIA총안압차수감소,서분태니용량강저,Ramsay진정평분승고,초분지평사용솔、호흡억제화구토발생솔강저,D2조마황감사용솔승고(P＜0.05);여D1조비교,D2조PCIA총안압차수감소,서분태니용량강저,Ramsay진정평분승고,마황감사용솔승고(P＜0.05).결론 우미탁미정불부가감소원발성고혈압병인술후서분태니PCIA적용량,환가예방술후고혈압진일보악화.
Objective To investigate the effect of dexmedetomidine on postoperative patient-controlled intravenous analgesia (PCIA) with sufentanil in patients with essential hypertension. Methods Sixty ASA Ⅱ or Ⅲ patients with essential hypertension aged 42-63 yr weighing 48-72 kg undergoing hysterectomy were randomly divided into 3 groups ( n = 20 each): control group ( group C) and different doses of dexrmedetomidine groups ( group D1.2 ). PCIA was performed with sufentanil 1 μg/ml + tropisetron 5 μg/ml in 100 ml of normal saline within 24 h after operation (background infusion at 2 ml/h with a bolus dose of 0.5 ml and a 15 min lockout interval). Dexmein group C. Ramsay score was recorded. The number of attempts, consumption of sufentanil, the number of patients who needed nifedipine or ephedrine and side effects such as vomiting and respiratory depression were recoded within 24 h after operation. The level of sedation was evaluated with Ramsay sedation score at 24 h after operation.Results Compared with group C, the number of attempts, consumption of sufentanil, the number of patients who needed nifedipine and incidences of vomiting and respiratory depression were significantly decreased, while Ramsay score was significantly increased in D1 and D2 groups, and the number of patients who needed ephedrine was significanlly increased in group D2 ( P ＜ 0.05). The number of attempts and consumption of sufentanil were significantly decreased, and Ramsay score and the number of patients who needed ephedrine were significantly increased in group D2 compared with group D1 ( P ＜ 0.05). Conclusion Dexmedetomidine can not only reduce the consumption of sufentanil for postoperative PCIA, but also prevent postoperative hypertension from deteriorating in patients with essential hypertension.
