中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2015年
5期
516-519
,共4页
右旋美托咪啶%镇静%丙泊酚%血流动力学
右鏇美託咪啶%鎮靜%丙泊酚%血流動力學
우선미탁미정%진정%병박분%혈류동역학
Dexmedetomidine%Sedation%Propofol%Hemodynamics
目的 探讨脑电双频指数(BIS)监测下右旋美托咪啶(Dex)对患者的镇静效应及血流动力学的影响.方法 选取潍坊医学院附属益都中心医院自2011年9月至2013年8月择期行全麻手术的胶质瘤患者80例,分为Dex组(45例)和对照组(35例).Dex组患者术前静脉注射0.4μg/kg Dex,5 min内注射完毕后以每小时0.4 μg/kg维持静脉滴注30 min;对照组患者以同样的方式注射等量生理盐水.2组患者的其他麻醉诱导、麻醉维持用药相同.记录2组患者注射Dex前(T0)、注射后即刻(T1)及静脉滴注后10 min(T2)、20 min(T3)和30 min(T4)的BIS值、心率(HR)、收缩压(SBP)、舒张压(DBP),并对患者进行警觉/镇静评分(OAA/S)、Ramesay镇静评分.结果 与对照组比较,Dex组患者T1、T2、T3和T4时的BIS和OAA/S评分较低、Ramsay评分较高,差异均有统计学意义(P＜0.05).与对照组比较,Dex组患者T1、T2、T3、T4时的HR较慢、T1、T2时的SBP较高,差异有统计学意义(P＜0.05).2组患者T3、T4时的SBP及T1、T2、T3、T4时的DBP比较差异均无统计学意义(P＞0.05).结论 静脉注射Dex可使清醒患者产生明显的镇静效应,加深麻醉手术患者的麻醉深度,引起HR减慢.
目的 探討腦電雙頻指數(BIS)鑑測下右鏇美託咪啶(Dex)對患者的鎮靜效應及血流動力學的影響.方法 選取濰坊醫學院附屬益都中心醫院自2011年9月至2013年8月擇期行全痳手術的膠質瘤患者80例,分為Dex組(45例)和對照組(35例).Dex組患者術前靜脈註射0.4μg/kg Dex,5 min內註射完畢後以每小時0.4 μg/kg維持靜脈滴註30 min;對照組患者以同樣的方式註射等量生理鹽水.2組患者的其他痳醉誘導、痳醉維持用藥相同.記錄2組患者註射Dex前(T0)、註射後即刻(T1)及靜脈滴註後10 min(T2)、20 min(T3)和30 min(T4)的BIS值、心率(HR)、收縮壓(SBP)、舒張壓(DBP),併對患者進行警覺/鎮靜評分(OAA/S)、Ramesay鎮靜評分.結果 與對照組比較,Dex組患者T1、T2、T3和T4時的BIS和OAA/S評分較低、Ramsay評分較高,差異均有統計學意義(P＜0.05).與對照組比較,Dex組患者T1、T2、T3、T4時的HR較慢、T1、T2時的SBP較高,差異有統計學意義(P＜0.05).2組患者T3、T4時的SBP及T1、T2、T3、T4時的DBP比較差異均無統計學意義(P＞0.05).結論 靜脈註射Dex可使清醒患者產生明顯的鎮靜效應,加深痳醉手術患者的痳醉深度,引起HR減慢.
목적 탐토뇌전쌍빈지수(BIS)감측하우선미탁미정(Dex)대환자적진정효응급혈류동역학적영향.방법 선취유방의학원부속익도중심의원자2011년9월지2013년8월택기행전마수술적효질류환자80례,분위Dex조(45례)화대조조(35례).Dex조환자술전정맥주사0.4μg/kg Dex,5 min내주사완필후이매소시0.4 μg/kg유지정맥적주30 min;대조조환자이동양적방식주사등량생리염수.2조환자적기타마취유도、마취유지용약상동.기록2조환자주사Dex전(T0)、주사후즉각(T1)급정맥적주후10 min(T2)、20 min(T3)화30 min(T4)적BIS치、심솔(HR)、수축압(SBP)、서장압(DBP),병대환자진행경각/진정평분(OAA/S)、Ramesay진정평분.결과 여대조조비교,Dex조환자T1、T2、T3화T4시적BIS화OAA/S평분교저、Ramsay평분교고,차이균유통계학의의(P＜0.05).여대조조비교,Dex조환자T1、T2、T3、T4시적HR교만、T1、T2시적SBP교고,차이유통계학의의(P＜0.05).2조환자T3、T4시적SBP급T1、T2、T3、T4시적DBP비교차이균무통계학의의(P＞0.05).결론 정맥주사Dex가사청성환자산생명현적진정효응,가심마취수술환자적마취심도,인기HR감만.
Objective To discuss the effect ofdexmedetomidine (Dex) on depth of sedation and hemodynamics in patients undergoing general anesthesia with monitor of bispectral index.Methods Eighty patients with gliomas,admitted to our hospital from September 2011 to August 2013 and accepted surgery under general anaesthesia,were randomly divided into Dex group and control group (n=45).Patients from the Dex group received intravenous injection of 0.4 μg/kg before operation;and 5 min after that,Dex at a loading dose of 0.4 μg/kg was given for 30 min;and 0.9％ normal saline was given to the control group.The bispectral index (BIS),heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP),observer assessment of alertness/sedation (OAA/S) scores and Ramsay sedation scale scores were monitored before Dex infusion (T0) and after loading (T1),and at 10,20,30 min (T2-T4) after continuous infusion.Results As compared with those in the control group,the BIS and OAA/S scores in the Dex group was significantly decreased,and the Ramsay sedation scale scores were statistically increased at T1,T2,T3 and T4 (P＜0.05);the HR at T1,T2,T3 and T4 was slower and the SBP at T1 and T2 was higher in the Dex group than those in the control group,with significant differences (P＜0.05).SBP at T3 and T4 and DBP at T1,T2,T3 and T4 showed no significant difference between the two groups (P＞0.05).Conclusion Intravenous Dex can make conscious patients has obvious sedative effects,deepen anesthesia depth of anesthesia surgery patients and reduce the dosage of propofol,and can cause HR decreasing.
