中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
8期
45-47
,共3页
右美托咪定%腰硬联合麻醉%盆底重建术%镇静遗忘
右美託咪定%腰硬聯閤痳醉%盆底重建術%鎮靜遺忘
우미탁미정%요경연합마취%분저중건술%진정유망
Dexmedetomidine%Combined spinal-epidural anesthesia%Reconstruction of pelvic floor%Sedation and amnesia
目的 观察右美托咪定在腰硬联合麻醉下行盆底重建术患者中的镇静及遗忘作用.方法 选择50例45～65岁、ASA Ⅰ～Ⅱ级拟在腰硬联合麻醉下行盆底重建术的女性患者,随机分为右美托咪定组(D组)和空白对照组(C组),每组25例.记录麻醉前(T)、麻醉后(T0)、用药后10 min(T1)、30 min(T2)、45 min(T3)、60 min(T4)及术毕时(T5)的平均动脉压(MAP)、基础心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2)、Ramsay评分,术后24h随访并记录患者用药后至手术结束对有关操作的遗忘程度.结果 T1 ～ T5时D组Ramsay评分显著高于C组(P＜0.05).T1～T5时D组MAP、HR低于C组(P＜0.05).RR、低氧血症发生率两组比较差异无统计学意义(P＞0.05).术后24h随访,D组患者对手术操作的遗忘程度明显高于C组(P＜0.01).结论 右美托咪定辅助应用于腰硬联合麻醉下盆底重建术中的镇静效果优越,呼吸抑制作用小,且有一定的顺行性遗忘,是一种安全有效的镇静药物.
目的 觀察右美託咪定在腰硬聯閤痳醉下行盆底重建術患者中的鎮靜及遺忘作用.方法 選擇50例45～65歲、ASA Ⅰ～Ⅱ級擬在腰硬聯閤痳醉下行盆底重建術的女性患者,隨機分為右美託咪定組(D組)和空白對照組(C組),每組25例.記錄痳醉前(T)、痳醉後(T0)、用藥後10 min(T1)、30 min(T2)、45 min(T3)、60 min(T4)及術畢時(T5)的平均動脈壓(MAP)、基礎心率(HR)、呼吸頻率(RR)、血氧飽和度(SpO2)、Ramsay評分,術後24h隨訪併記錄患者用藥後至手術結束對有關操作的遺忘程度.結果 T1 ～ T5時D組Ramsay評分顯著高于C組(P＜0.05).T1～T5時D組MAP、HR低于C組(P＜0.05).RR、低氧血癥髮生率兩組比較差異無統計學意義(P＞0.05).術後24h隨訪,D組患者對手術操作的遺忘程度明顯高于C組(P＜0.01).結論 右美託咪定輔助應用于腰硬聯閤痳醉下盆底重建術中的鎮靜效果優越,呼吸抑製作用小,且有一定的順行性遺忘,是一種安全有效的鎮靜藥物.
목적 관찰우미탁미정재요경연합마취하행분저중건술환자중적진정급유망작용.방법 선택50례45～65세、ASA Ⅰ～Ⅱ급의재요경연합마취하행분저중건술적녀성환자,수궤분위우미탁미정조(D조)화공백대조조(C조),매조25례.기록마취전(T)、마취후(T0)、용약후10 min(T1)、30 min(T2)、45 min(T3)、60 min(T4)급술필시(T5)적평균동맥압(MAP)、기출심솔(HR)、호흡빈솔(RR)、혈양포화도(SpO2)、Ramsay평분,술후24h수방병기록환자용약후지수술결속대유관조작적유망정도.결과 T1 ～ T5시D조Ramsay평분현저고우C조(P＜0.05).T1～T5시D조MAP、HR저우C조(P＜0.05).RR、저양혈증발생솔량조비교차이무통계학의의(P＞0.05).술후24h수방,D조환자대수술조작적유망정도명현고우C조(P＜0.01).결론 우미탁미정보조응용우요경연합마취하분저중건술중적진정효과우월,호흡억제작용소,차유일정적순행성유망,시일충안전유효적진정약물.
Objective To observe the sedation and amnesia effect of dexmedetomidine on combined spinal-epidural anesthesia in patients with pelvic floor reconstruction.Methods Fifty female patients with 45 to 65 years old,ASA I-Ⅱ scheduled for pelvic reconstructive surgery under combined spinal-epidural anesthesia,were randomly divided into two groups (n =25):dexmedetomidine group (D group),blank control group (group C).MAP,HR,RR and SpO2,Ramsay score was recorded before anesthesia (T),after combined spinal-epidural anesthesia (T0),10 min (T1),30 min (T2),45 min (T3),60 min (T4) after the treatment and at the end of operation (T5),and the forgetting degree of related procedure from medication to the ending of the operation during the 24 h follow-up was recorded.Results Ramsay score was significantly higher at T1-5 in group D than that in group C (P ＜ 0.05).MAP,HR levels were lower at T1-5 in group D than those in group C (P ＜ 0.05).There were no significant differences in RR,the incidence of hypoxemia between the two groups (P ＞ 0.05).During the 24 h follow-up after operation,patients in group D had higher forgetting degree of operation than group C (P ＜ 0.01).Conclusions Dexmedetomidine auxiliary used in combined spinal-epidural anesthesia for reconstruction of pelvic floor is superior in sedation effect,has little respiratory depression effect,and certain anterograde amnesia,is a safe and effective sedation.
