CAJ | 학술논문

[目的]探讨右美托咪定辅助应用于老年人和青年人硬膜外麻醉后的镇静、镇痛和抗不良反应效果。[方法]本院2010年6月至2012年3月收治拟行硬膜外麻醉手术的患者60例，ASA 评分 I～II 级，按年龄段分为老年组（60～80岁）和青年组（25～45岁），每组各30例。硬膜外麻醉效果满意后，通过警觉/镇静评分（OAA/S）评估镇静程度，调整右美托咪定的输注速率使 OAA/S 评分维持1～2分，手术结束后停用右美托咪定。记录患者的麻醉时间、手术时间、停药后呼唤睁眼时间及 OAA/S 评分达4分和5分的时间；同时观察两组患者预防腹部牵扯反应有效率及术中不良反应发生情况并加以总结分析。[结果]老年组和青年组麻醉时间、手术时间、停药后呼唤睁眼时间及 OAA/S 评分达4分和5分的时间无明显差异（P ＞0．05）；预防腹部牵拉反应有效率方面，两组亦无明显差异（P ＞0．05）。[结论]右美托咪定应用于一般情况好的老年人硬膜外麻醉腹部手术有良好的镇静及预防牵拉反应作用，是一种安全有效的麻醉方式。
[목적]탐토우미탁미정보조응용우노년인화청년인경막외마취후적진정、진통화항불량반응효과。[방법]본원2010년6월지2012년3월수치의행경막외마취수술적환자60례，ASA 평분 I～II 급，안년령단분위노년조（60～80세）화청년조（25～45세），매조각30례。경막외마취효과만의후，통과경각/진정평분（OAA/S）평고진정정도，조정우미탁미정적수주속솔사 OAA/S 평분유지1～2분，수술결속후정용우미탁미정。기록환자적마취시간、수술시간、정약후호환정안시간급 OAA/S 평분체4분화5분적시간；동시관찰량조환자예방복부견차반응유효솔급술중불량반응발생정황병가이총결분석。[결과]노년조화청년조마취시간、수술시간、정약후호환정안시간급 OAA/S 평분체4분화5분적시간무명현차이（P ＞0．05）；예방복부견랍반응유효솔방면，량조역무명현차이（P ＞0．05）。[결론]우미탁미정응용우일반정황호적노년인경막외마취복부수술유량호적진정급예방견랍반응작용，시일충안전유효적마취방식。
[Objective]To explore the sedative,analgesia and anti-adverse reaction effect of dexmedetomi-dine(Dex)used in epidural anesthesia for senile and young patients.[Methods]Sixty ASA Ⅰ ~ Ⅱ patients scheduled for the operation under epidural anesthesia admitted to our hospital from Jun.2010 to March 2012 were divided into senile group(60~80 years old,n =30)and young group(25~45 years old,n =30)accord-ing to the age.After epidural anesthesia achieved satisfactory effect,alertness/sedation score(OAA/S)was used to assess the sedative level.The transfusion velocity of Dex was adjusted to maintain 1 ~ 2 scores of OAA/S.After the operation,Dex was stopped.The anesthesia time,operation time,awake time and the time to reach 4 and 5 scores of OAA/S of patients were recorded.The effective rate of preventing abdominal stretch response and the incidence of intraoperative adverse reaction of patients in two groups were observed and ana-lyzed.[Results]There was no significant difference in anesthesia time,operation time,awake time and the time to reach 4 and 5 scores of OAA/S between senile group and young group(P >0.05).There was no sig-nificant difference in the effective rate of preventing abdominal stretch response between two groups(P >0.05).[Conclusion]Dex used in epidural anesthesia for elderly patients with good general condition undergo-ing abdominal surgery has good sedative effect and can prevent abdominal stretch response,so it is a safe and effective anesthesia method.