中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2013年
22期
96-97,102
,共3页
右美托咪定%咪唑安定%晶体植入手术
右美託咪定%咪唑安定%晶體植入手術
우미탁미정%미서안정%정체식입수술
Dexmedetomidine%Midazolam%Cataract extraction intraocular lens implantation
目的:比较不同剂量的右美托咪定(DEX)用于老年晶体植入术中的安全性和有效性。方法 ASA Ⅰ或Ⅱ级择期行晶体植入手术的老年患者92例,随机均分为低剂量右美托咪定组(D1组)、中剂量右美托咪定组(D2组)、高剂量右美托咪定组(D3组)、咪达唑仑组(M组)。D1组,DEX 0.4μg/kg,用生理盐水稀释成20mL,静脉泵注10min,D2组,DEX 0.7μg/kg,给药方法同D1组;D3组,DEX 1.0μg/kg,给药方法同D1组;M 组手术开始前10min 输注咪达唑仑0.03mg/kg。观察记录患者麻醉前(T0)、用药后10 min(T1)、15 min(T2)、30 min(T3)、60min(T4)平均动脉压(MAP)、心率(HR)、RR(呼吸次数)、血氧饱和度(SpO2)。同时观察三组术中、术后不良反应及医生和患者满意度。结果与麻醉前比较,D组患者MAP、HR 有显著性差异(P<0.05)。D2、D3组术中体动发生率、术后谵妄的发生率、低于D1组(P<0.05)和M组(P<0.05)。D组医生和患者满意度高于M组(P<0.05)。结论中、高剂量右美托咪定应用于晶体植入手术患者安全有效;镇静镇痛效果好;术中、术后不良反应发生率低且医师和患者满意度高。
目的:比較不同劑量的右美託咪定(DEX)用于老年晶體植入術中的安全性和有效性。方法 ASA Ⅰ或Ⅱ級擇期行晶體植入手術的老年患者92例,隨機均分為低劑量右美託咪定組(D1組)、中劑量右美託咪定組(D2組)、高劑量右美託咪定組(D3組)、咪達唑崙組(M組)。D1組,DEX 0.4μg/kg,用生理鹽水稀釋成20mL,靜脈泵註10min,D2組,DEX 0.7μg/kg,給藥方法同D1組;D3組,DEX 1.0μg/kg,給藥方法同D1組;M 組手術開始前10min 輸註咪達唑崙0.03mg/kg。觀察記錄患者痳醉前(T0)、用藥後10 min(T1)、15 min(T2)、30 min(T3)、60min(T4)平均動脈壓(MAP)、心率(HR)、RR(呼吸次數)、血氧飽和度(SpO2)。同時觀察三組術中、術後不良反應及醫生和患者滿意度。結果與痳醉前比較,D組患者MAP、HR 有顯著性差異(P<0.05)。D2、D3組術中體動髮生率、術後譫妄的髮生率、低于D1組(P<0.05)和M組(P<0.05)。D組醫生和患者滿意度高于M組(P<0.05)。結論中、高劑量右美託咪定應用于晶體植入手術患者安全有效;鎮靜鎮痛效果好;術中、術後不良反應髮生率低且醫師和患者滿意度高。
목적:비교불동제량적우미탁미정(DEX)용우노년정체식입술중적안전성화유효성。방법 ASA Ⅰ혹Ⅱ급택기행정체식입수술적노년환자92례,수궤균분위저제량우미탁미정조(D1조)、중제량우미탁미정조(D2조)、고제량우미탁미정조(D3조)、미체서륜조(M조)。D1조,DEX 0.4μg/kg,용생리염수희석성20mL,정맥빙주10min,D2조,DEX 0.7μg/kg,급약방법동D1조;D3조,DEX 1.0μg/kg,급약방법동D1조;M 조수술개시전10min 수주미체서륜0.03mg/kg。관찰기록환자마취전(T0)、용약후10 min(T1)、15 min(T2)、30 min(T3)、60min(T4)평균동맥압(MAP)、심솔(HR)、RR(호흡차수)、혈양포화도(SpO2)。동시관찰삼조술중、술후불량반응급의생화환자만의도。결과여마취전비교,D조환자MAP、HR 유현저성차이(P<0.05)。D2、D3조술중체동발생솔、술후섬망적발생솔、저우D1조(P<0.05)화M조(P<0.05)。D조의생화환자만의도고우M조(P<0.05)。결론중、고제량우미탁미정응용우정체식입수술환자안전유효;진정진통효과호;술중、술후불량반응발생솔저차의사화환자만의도고。
Objective To observe the safety and efficacy of dexmedetomidine on aged patients undergoing cataract extraction combined with intraocular lens implantation. Methods 92 patients (ASA Ⅰor Ⅱ)were randomly divided into four groups, with 23 cases in each group (n=23), midazolam group (group M)low-dose DEX group (D1 group), medium-dose DEX group(D2 group), high-dose DEX group (D3 group). MAP, HR, RR,SpO2 were recorded before anesthesia, after 10 min begin infusion of DEX and 15, 30 and 60 min At the same time, the degree of satisfaction of doctors and patients were recorded. Results In DEX groups, HR and MAP decreased significantly at T1-T3 compared with T0 (P < 0.05) . The incidence of adverse reaction was significantly lower in group D2 and group D3 Compared with group D1 (P<0.05) and group M (P<0.05). At the times, the degree of satisfaction of doctors and patients Was higher than D1 group (P <0.05), M group (P <0.01) . Conclusion Aged patients undergoing cataract extraction combined with intraocular lens implantation is safe and effective;Calm analgesic the effect for sedation and analgesia is good;The incidence of adverse reaction of perioperative and postoperative is lower and doctors and patients satisfaction is higher.