中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2014年
8期
624-627
,共4页
张斯%付琦%康鑫鑫%王元
張斯%付琦%康鑫鑫%王元
장사%부기%강흠흠%왕원
右美托咪定%麻醉%手术,眼科
右美託咪定%痳醉%手術,眼科
우미탁미정%마취%수술,안과
Dexmedetomidine%Anesthesia%Surgery,ophthalmic
目的 探讨不同剂量的右美托咪定在眼科局麻手术中的镇静效果及其安全性.方法 眼外伤手术60例,随机分为3组,每组20例.B、C组右美托咪啶负荷剂量0.5 μg/kg微量泵＞10min输注,A组等量、等时生理盐水微量泵输注.之后B组以0.3 μg/kg/h、C组以0.6μg/kg/h维持至手术结束,A组以等量生理盐水维持至手术结束.记录三组患者血压给药前基础值(T0)、给负荷药量或盐水结束(T1)、给药或盐水30 min(T2)、给药或盐水60 min(T3)、手术结束(T4)时的镇静评分及收缩压、舒张压、心率、脉搏血氧饱和度(SpO2)的变化.结果 三组患者在年龄、身高、体重和手术时间上比较差异无统计学意义.与A组比较,B组、C组Ramsay镇静评分在T2～T4时间点明显升高,差别有统计学意义;各时间点SpO2比较,差异无统计学意义.与To比较,A组收缩压、舒张压、心率在T1～T4时间点均明显升高,差异有统计学意义;收缩压在B组T3～ T4、C组T2～ T4均降低,B组、C组心率T1～ T4均降低,差异有统计学意义;与A组比较,B、C组收缩压、舒张压、心率在T1～ T2时间点均明显降低,差异有统计学意义.结论 右美托咪定负荷剂量0.5 μg/kg、维持剂量0.3μ/kg微量泵输注,能够为复合局部麻醉提供良好的镇静作用,并安全地应用于眼科手术患者.
目的 探討不同劑量的右美託咪定在眼科跼痳手術中的鎮靜效果及其安全性.方法 眼外傷手術60例,隨機分為3組,每組20例.B、C組右美託咪啶負荷劑量0.5 μg/kg微量泵＞10min輸註,A組等量、等時生理鹽水微量泵輸註.之後B組以0.3 μg/kg/h、C組以0.6μg/kg/h維持至手術結束,A組以等量生理鹽水維持至手術結束.記錄三組患者血壓給藥前基礎值(T0)、給負荷藥量或鹽水結束(T1)、給藥或鹽水30 min(T2)、給藥或鹽水60 min(T3)、手術結束(T4)時的鎮靜評分及收縮壓、舒張壓、心率、脈搏血氧飽和度(SpO2)的變化.結果 三組患者在年齡、身高、體重和手術時間上比較差異無統計學意義.與A組比較,B組、C組Ramsay鎮靜評分在T2～T4時間點明顯升高,差彆有統計學意義;各時間點SpO2比較,差異無統計學意義.與To比較,A組收縮壓、舒張壓、心率在T1～T4時間點均明顯升高,差異有統計學意義;收縮壓在B組T3～ T4、C組T2～ T4均降低,B組、C組心率T1～ T4均降低,差異有統計學意義;與A組比較,B、C組收縮壓、舒張壓、心率在T1～ T2時間點均明顯降低,差異有統計學意義.結論 右美託咪定負荷劑量0.5 μg/kg、維持劑量0.3μ/kg微量泵輸註,能夠為複閤跼部痳醉提供良好的鎮靜作用,併安全地應用于眼科手術患者.
목적 탐토불동제량적우미탁미정재안과국마수술중적진정효과급기안전성.방법 안외상수술60례,수궤분위3조,매조20례.B、C조우미탁미정부하제량0.5 μg/kg미량빙＞10min수주,A조등량、등시생리염수미량빙수주.지후B조이0.3 μg/kg/h、C조이0.6μg/kg/h유지지수술결속,A조이등량생리염수유지지수술결속.기록삼조환자혈압급약전기출치(T0)、급부하약량혹염수결속(T1)、급약혹염수30 min(T2)、급약혹염수60 min(T3)、수술결속(T4)시적진정평분급수축압、서장압、심솔、맥박혈양포화도(SpO2)적변화.결과 삼조환자재년령、신고、체중화수술시간상비교차이무통계학의의.여A조비교,B조、C조Ramsay진정평분재T2～T4시간점명현승고,차별유통계학의의;각시간점SpO2비교,차이무통계학의의.여To비교,A조수축압、서장압、심솔재T1～T4시간점균명현승고,차이유통계학의의;수축압재B조T3～ T4、C조T2～ T4균강저,B조、C조심솔T1～ T4균강저,차이유통계학의의;여A조비교,B、C조수축압、서장압、심솔재T1～ T2시간점균명현강저,차이유통계학의의.결론 우미탁미정부하제량0.5 μg/kg、유지제량0.3μ/kg미량빙수주,능구위복합국부마취제공량호적진정작용,병안전지응용우안과수술환자.
Objective To evaluate the efficacy and security of different doses of dexmedetomidine on patients undergoing ophthalmic surgery with local anesthesia.Methods Sixty patients with ocular trauma surgery were randomly divided into three groups (20 cases in each group).Dexmedetomidine in group B and C were administrated with micro-pumps in a loading dose of 0.5 μg/kg over 10 mins,and at the same time,the same amount of normal saline was pumped in the same way in group A.Then dexmedetomidine was pumped as 0.3 μg/kg/h in group B and 0.6 μg/kg/h in group C,and normal saline was maintained in group A until the end of surgery.The Ramsay sedation score,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),pulse oxygen saturation (SpO2) of the three groups were recorded.The time-points included before the administration(T0),the end of load measurement(T1),30 min after administration(T2),60 min after administration(T3) and the end of operation(T4).Results There were no significant differences in age,height,weight,operation time and SpO2 at each time point among the three groups.Compared with group A,Ramsay sedation score in group B and group C were significantly higher in T2-T4 time points,and the difference had statistical significance.Compared with To,the SBP,DBP and HR of group A were much higher in T1-T4,and the difference was statistically significant.The SBP decreased in T3-T4 of group B and T2-T4 of group C.The HR of group B and C decreased in T1-T4,and the difference was statistically significant.Conclusion Dexmedetomidine combined with local anesthesia can provide good sedation in ophthalmic surgery with a loading dose of 0.5 μg/kg and maintenance dose of 0.3 μg/kg.
