安徽医科大学学报
安徽醫科大學學報
안휘의과대학학보
ACTA UNIVERSITY MEDICINALIS ANHUI
2014年
1期
88-91
,共4页
王红仙%张野%李云%王斌
王紅仙%張野%李雲%王斌
왕홍선%장야%리운%왕빈
右美托咪定%全身麻醉%胃癌根治术%镇静%镇痛
右美託咪定%全身痳醉%胃癌根治術%鎮靜%鎮痛
우미탁미정%전신마취%위암근치술%진정%진통
dexmedetomidine%general anesthesia%gastrectomy%sedation%analgesia
目的观察胃癌根治术中右美托咪定辅助全身麻醉对患者围术期血流动力学、麻醉药用量以及术后镇静镇痛的影响。方法择期全麻行胃癌根治术患者40例,随机均分为右美托咪定(D)组和对照(C)组,D组麻醉诱导前15 min静脉泵注右美托咪定0.6μg/kg,维持为0.4μg/(kg·h),直至术毕前40 min,C组则给予等量的生理盐水。观察注药前(T1)、麻醉诱导前(T2)、气管插管前即刻(T3)、插管后1 min( T4)、切皮时( T5)、探查时( T6)、拔管后即刻( T7)的脑双频指数( BIS)、平均动脉压( MAP)、心率( HR),记录丙泊酚和瑞芬太尼的用量,术后4 h内的镇静评分Ramsay和视觉模拟评分VAS情况。结果 T2时D组BIS值明显低于T1和C组(P<0.01)；与C组比较,T2、T4~T7时D组MAP 明显降低,HR明显减慢(P<0.05,P<0.01)； D组丙泊酚和瑞芬太尼的用量明显低于C组(P<0.05)；D组术后1 h和4 h的Ramsay评分明显高于C组、VAS评分明显低C组( P<0.05)。结论右美托咪定辅助全身麻醉可产生明显的镇静,镇痛效应,减少麻醉药的用量,降低了患者术后的不适感。
目的觀察胃癌根治術中右美託咪定輔助全身痳醉對患者圍術期血流動力學、痳醉藥用量以及術後鎮靜鎮痛的影響。方法擇期全痳行胃癌根治術患者40例,隨機均分為右美託咪定(D)組和對照(C)組,D組痳醉誘導前15 min靜脈泵註右美託咪定0.6μg/kg,維持為0.4μg/(kg·h),直至術畢前40 min,C組則給予等量的生理鹽水。觀察註藥前(T1)、痳醉誘導前(T2)、氣管插管前即刻(T3)、插管後1 min( T4)、切皮時( T5)、探查時( T6)、拔管後即刻( T7)的腦雙頻指數( BIS)、平均動脈壓( MAP)、心率( HR),記錄丙泊酚和瑞芬太尼的用量,術後4 h內的鎮靜評分Ramsay和視覺模擬評分VAS情況。結果 T2時D組BIS值明顯低于T1和C組(P<0.01)；與C組比較,T2、T4~T7時D組MAP 明顯降低,HR明顯減慢(P<0.05,P<0.01)； D組丙泊酚和瑞芬太尼的用量明顯低于C組(P<0.05)；D組術後1 h和4 h的Ramsay評分明顯高于C組、VAS評分明顯低C組( P<0.05)。結論右美託咪定輔助全身痳醉可產生明顯的鎮靜,鎮痛效應,減少痳醉藥的用量,降低瞭患者術後的不適感。
목적관찰위암근치술중우미탁미정보조전신마취대환자위술기혈류동역학、마취약용량이급술후진정진통적영향。방법택기전마행위암근치술환자40례,수궤균분위우미탁미정(D)조화대조(C)조,D조마취유도전15 min정맥빙주우미탁미정0.6μg/kg,유지위0.4μg/(kg·h),직지술필전40 min,C조칙급여등량적생리염수。관찰주약전(T1)、마취유도전(T2)、기관삽관전즉각(T3)、삽관후1 min( T4)、절피시( T5)、탐사시( T6)、발관후즉각( T7)적뇌쌍빈지수( BIS)、평균동맥압( MAP)、심솔( HR),기록병박분화서분태니적용량,술후4 h내적진정평분Ramsay화시각모의평분VAS정황。결과 T2시D조BIS치명현저우T1화C조(P<0.01)；여C조비교,T2、T4~T7시D조MAP 명현강저,HR명현감만(P<0.05,P<0.01)； D조병박분화서분태니적용량명현저우C조(P<0.05)；D조술후1 h화4 h적Ramsay평분명현고우C조、VAS평분명현저C조( P<0.05)。결론우미탁미정보조전신마취가산생명현적진정,진통효응,감소마취약적용량,강저료환자술후적불괄감。
Objective To investigate the effect of hemodynamics, the amount of anesthetic, sedation and analgesia perioperative administered dexmedetomidine in gastrectomy in general anesthesia. Methods Forty patients ( ASAI~II) scheduled for elective gastrectomy under general anesthesia were enrolled in this study. All patients were randomly divided into two groups:dexmedetomidine group ( group D) and control group ( group C) . In group D, 0 . 6 μg/kg of the loading dose dexmedetomidine was administered intravenously by micro-pump for within 15 mi-nutes before induction of anesthesia, then 0.4 μg/(kg·h) was maintained until the 40th min end of surgery. While in group C, the same volume of normal saline was given by the same way. The parameters of BIS, MAP and HR were recored before dexmedetomidine or normal saline infused intravenously ( T1 ) , before the induction of an-esthesia (T2), immediately after intubation ( T3 ), 1min after intubation ( T4 ), immediately after skin incision ( T5 ) , immediately after operation exploration ( T6 ) , immediately after extubation ( T7 ) . The parameters were re-corded such as the amount of propofol and remifentanil, Ramsay and VAS score within four hours after operation. Results Compared to those at T1 and group C, BIS scale of group D at T2 showed significantly decrease ( P <0.01). MAP, HR in group C had a significant increase than those in the group D at T2,T4 ~T7(P<0.05 or P<0.01 ) . Propofol and remifentanil consumption in group D were less than those in group C ( P<0.05 ) . 1 h and 4 h after operation, the Ramsay score in group D was significantly higher than that in group C, the VAS score in group D was significantly lower than that in group C ( P<0.05 ) . Conclusion The application of dexmedetomi-dine in general anesthesia can produce significant sedation, improve the effect of analgesia, reduce the amount of anesthetic and postoperative discomfort.
