中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
33期
25-26
,共2页
帕瑞昔布钠%超前镇痛%右美托咪啶%气管切开%临床麻醉
帕瑞昔佈鈉%超前鎮痛%右美託咪啶%氣管切開%臨床痳醉
파서석포납%초전진통%우미탁미정%기관절개%림상마취
Parecoxib%Preemptive analgesia%Dexmedetomidine%Tracheostomy%MAC
目的：在气管切开MAC中，将局麻联合帕瑞昔布钠超前镇痛和右美托咪啶泵注与单纯局麻进行对比，对前者的麻醉效果进行评估。方法：ASAⅡ~Ⅲ级40例行气管切开手术的患者，按照随机数字表法将其分为镇痛组（局麻+帕瑞昔布钠右美托咪啶组）和对照组（单纯局麻组），每组20例。镇痛组切皮前30 min静注帕瑞昔布钠40 mg，同时微量泵持续静脉注射右美托咪啶1μg/kg（15 min内注射完毕），随后右美托咪啶0.4μg/（kg·h）持续泵注，观察并记录两组给药前（T0）、切皮时（T1）、深部手术操作（T2）、缝皮时（T3）4个时点患者的血压（SP、DP）、心率（HR），血氧饱和度（SpO2）和术中体动反应个数。结果：切开气管操作时，对照组与镇痛组比较，心率、血压、明显上升，体动个数明显增多，差异均有统计学意义（P<0.05），术中有62%的患者需要追加深部局部浸润麻醉。两组SpO2各时点比较差异无统计学意义（P>0.05）。结论：局麻联合帕瑞昔布钠超前镇痛和右美托咪啶泵注用于气管切开患者，镇静镇痛效果好，呼吸循环稳定。
目的：在氣管切開MAC中，將跼痳聯閤帕瑞昔佈鈉超前鎮痛和右美託咪啶泵註與單純跼痳進行對比，對前者的痳醉效果進行評估。方法：ASAⅡ~Ⅲ級40例行氣管切開手術的患者，按照隨機數字錶法將其分為鎮痛組（跼痳+帕瑞昔佈鈉右美託咪啶組）和對照組（單純跼痳組），每組20例。鎮痛組切皮前30 min靜註帕瑞昔佈鈉40 mg，同時微量泵持續靜脈註射右美託咪啶1μg/kg（15 min內註射完畢），隨後右美託咪啶0.4μg/（kg·h）持續泵註，觀察併記錄兩組給藥前（T0）、切皮時（T1）、深部手術操作（T2）、縫皮時（T3）4箇時點患者的血壓（SP、DP）、心率（HR），血氧飽和度（SpO2）和術中體動反應箇數。結果：切開氣管操作時，對照組與鎮痛組比較，心率、血壓、明顯上升，體動箇數明顯增多，差異均有統計學意義（P<0.05），術中有62%的患者需要追加深部跼部浸潤痳醉。兩組SpO2各時點比較差異無統計學意義（P>0.05）。結論：跼痳聯閤帕瑞昔佈鈉超前鎮痛和右美託咪啶泵註用于氣管切開患者，鎮靜鎮痛效果好，呼吸循環穩定。
목적：재기관절개MAC중，장국마연합파서석포납초전진통화우미탁미정빙주여단순국마진행대비，대전자적마취효과진행평고。방법：ASAⅡ~Ⅲ급40례행기관절개수술적환자，안조수궤수자표법장기분위진통조（국마+파서석포납우미탁미정조）화대조조（단순국마조），매조20례。진통조절피전30 min정주파서석포납40 mg，동시미량빙지속정맥주사우미탁미정1μg/kg（15 min내주사완필），수후우미탁미정0.4μg/（kg·h）지속빙주，관찰병기록량조급약전（T0）、절피시（T1）、심부수술조작（T2）、봉피시（T3）4개시점환자적혈압（SP、DP）、심솔（HR），혈양포화도（SpO2）화술중체동반응개수。결과：절개기관조작시，대조조여진통조비교，심솔、혈압、명현상승，체동개수명현증다，차이균유통계학의의（P<0.05），술중유62%적환자수요추가심부국부침윤마취。량조SpO2각시점비교차이무통계학의의（P>0.05）。결론：국마연합파서석포납초전진통화우미탁미정빙주용우기관절개환자，진정진통효과호，호흡순배은정。
Objective:To compare local anesthesia jointly used with parecoxib preemptive analgesia and dexmedetomidine injection with simple local anesthesia in monitored anesthesia care(MAC) of patients receiving tracheostomy and to evaluate the anesthetic effect of the former.Method:ASAⅡ-Ⅲ forty patients with tracheostomy were randomly divided into the analgesia group and the control group,20 cases in each group.Thirty minutes before incision,the analgesia group was given parecoxib 40 mg,during which 1 μg/kg of continuous intravenous infusion of dexmedetomidine in 15 minutes was given the micro infusion pump and later a 0.4 μg/(kg·h)continous dexmedetomidine injection was given.Then a series of patients’ indexes including Bp(SP,DP),HR,SpO2 and the number of body activities were observed and recorded at such four timings as:pre-infusion(T0), cut skin (T1),deep operation (T2) and surgical sutures(T3).Result:Cut windpipe operation,the control group compared with analgesia group, increased heart rate,blood pressure and body move number increased significantly,the difference had statistical significance (P<0.05),in 62% of patients required additional deep local infiltration anesthesia.SpO2 each point was similar between the two groups has no statistical significance (P>0.05). Conclusion:The use of local anesthesia combined with parecoxib preemptive analgesia and dexmedetomidine used for patients after tracheostomy,it can yield marked analgesic and sedative effect and stable respiration and circulation.
