中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
17期
27-29
,共3页
右美托咪定%颈神经丛阻滞%血流动力学
右美託咪定%頸神經叢阻滯%血流動力學
우미탁미정%경신경총조체%혈류동역학
Dexmedetomidine%Cervical plexus block%Hemodynamics
目的 观察颈神经丛阻滞甲状腺手术辅以右美托咪定的应用效果.方法 择期甲状腺手术患者60例,ASA Ⅰ或Ⅱ级,随机分为三组:右美托咪定组(D组)、咪达唑仑组(M组)和对照组(C组).三组都以改良一针法和相同局部麻醉药施颈神经丛阻滞.D组在阻滞前泵注右美托咪定负荷量1 μg/kg,恒速10 min,持续量0.4～0.6 μg/(kg·h).M组在阻滞后静脉注射咪达唑仑0.04 mg/kg.记录基础值(T0)、颈神经丛阻滞后10 min(T1)、20 min(T2)、30 min(T3)及手术结束时(T4)的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(SpO2)和SBP与HR的乘积(RPP).结果 C组T1～T4各指标均明显高于T0时(P＜0.05)；M组和D组T1～T4各指标均明显低于C组(P＜0.05)；D组较M组T1～T4各指标虽稍低但无统计学意义(P＞0.05).结论 甲状腺手术辅以右美托咪定镇静、镇痛效果可靠,能有效抑制颈神经丛阻滞导致的心血管不良反应.
目的 觀察頸神經叢阻滯甲狀腺手術輔以右美託咪定的應用效果.方法 擇期甲狀腺手術患者60例,ASA Ⅰ或Ⅱ級,隨機分為三組:右美託咪定組(D組)、咪達唑崙組(M組)和對照組(C組).三組都以改良一針法和相同跼部痳醉藥施頸神經叢阻滯.D組在阻滯前泵註右美託咪定負荷量1 μg/kg,恆速10 min,持續量0.4～0.6 μg/(kg·h).M組在阻滯後靜脈註射咪達唑崙0.04 mg/kg.記錄基礎值(T0)、頸神經叢阻滯後10 min(T1)、20 min(T2)、30 min(T3)及手術結束時(T4)的收縮壓(SBP)、舒張壓(DBP)、心率(HR)、脈搏血氧飽和度(SpO2)和SBP與HR的乘積(RPP).結果 C組T1～T4各指標均明顯高于T0時(P＜0.05)；M組和D組T1～T4各指標均明顯低于C組(P＜0.05)；D組較M組T1～T4各指標雖稍低但無統計學意義(P＞0.05).結論 甲狀腺手術輔以右美託咪定鎮靜、鎮痛效果可靠,能有效抑製頸神經叢阻滯導緻的心血管不良反應.
목적 관찰경신경총조체갑상선수술보이우미탁미정적응용효과.방법 택기갑상선수술환자60례,ASA Ⅰ혹Ⅱ급,수궤분위삼조:우미탁미정조(D조)、미체서륜조(M조)화대조조(C조).삼조도이개량일침법화상동국부마취약시경신경총조체.D조재조체전빙주우미탁미정부하량1 μg/kg,항속10 min,지속량0.4～0.6 μg/(kg·h).M조재조체후정맥주사미체서륜0.04 mg/kg.기록기출치(T0)、경신경총조체후10 min(T1)、20 min(T2)、30 min(T3)급수술결속시(T4)적수축압(SBP)、서장압(DBP)、심솔(HR)、맥박혈양포화도(SpO2)화SBP여HR적승적(RPP).결과 C조T1～T4각지표균명현고우T0시(P＜0.05)；M조화D조T1～T4각지표균명현저우C조(P＜0.05)；D조교M조T1～T4각지표수초저단무통계학의의(P＞0.05).결론 갑상선수술보이우미탁미정진정、진통효과가고,능유효억제경신경총조체도치적심혈관불량반응.
Objective To observe the application effect of cervical plexus block thyroid operation with dexmedetomidine.Methods Selective thyroid operation in 60 cases,ASA Ⅰ or Ⅱ,were randomly divided into three groups:dexmedetomidine group (group D),midazolam group (group M) and control group (group C).The three groups were given improved method and the same application of cervical plexus block with local anesthetics.Dexmedetomidine of 1 μg/kg was infused before block in group D for 10 min,with constant speed,constant amount of 0.4-0.6 μg/(kg · h).In group M,intravenous injection of midazolam 0.04 mg/kg were given.The base value (T0),cervical plexus block after 10 min (T1),20 min (T2),30 min (T3) and SBP,DBP,HR,SpO2 and SBP and HR (RPP) at the end of openation (T4) were recorded.Results In group C,each indexes in T1-T4 were significantly higher than those in T0 (P ＜ 0.05) ; each indexes in group M and D T1-T4 were significantly lower than those in group C (P ＜ 0.05) ; each indixes in group D than in group M at T1-T4,but there was no significant difference (P ＞ 0.05).Conclusions Thyroid operation with dexmedetomidine sedation,analgesia effect is reliable,and can effectively inhibit the cardiovascular side effects in cervical plexus block.
