CAJ | 학술논문

目的：评价右美托咪定复合瑞芬太尼在椎间孔镜手术中的应用效果及安全性。方法选取80例在我院行椎间孔镜手术的患者,采取随机数字表法,将其分为2组：右美托咪定复合瑞芬太尼组(D组)和局麻组( L组),每组40例。采用双盲法, D 组手术开始前10 min 静脉推注右美托咪定1μg/kg 和瑞芬太尼0．5μg/kg,随后持续输注右美托咪定0．5μg/( kg·h)+瑞芬太尼0．05μg/( kg·min)。 L组常规手术前给予1%利多卡因局麻。记录给药前(T0)、手术开始时(T1)、手术开始10 min 后(T2)、手术结束时(T3)、手术结束后30 min ( T4)的平均动脉压( MAP)、心率( HR)、呼吸频率( RR)的变化,记录患者手术时间、术中不良反应及并发症,患者和手术医生的满意度；应用Ramsay评分评价患者的镇静效果,并调查患者和骨科医生的满意度。结果L组T2、T3时, HR、MAP 均明显升高( P <0．05)；与 D 组比较, L 组镇静效果及医患满意度均明显降低(P<0．05)。结论右美托咪定复合瑞芬太尼应用于椎间孔镜手术安全有效,值得在临床推广。
목적：평개우미탁미정복합서분태니재추간공경수술중적응용효과급안전성。방법선취80례재아원행추간공경수술적환자,채취수궤수자표법,장기분위2조：우미탁미정복합서분태니조(D조)화국마조( L조),매조40례。채용쌍맹법, D 조수술개시전10 min 정맥추주우미탁미정1μg/kg 화서분태니0．5μg/kg,수후지속수주우미탁미정0．5μg/( kg·h)+서분태니0．05μg/( kg·min)。 L조상규수술전급여1%리다잡인국마。기록급약전(T0)、수술개시시(T1)、수술개시10 min 후(T2)、수술결속시(T3)、수술결속후30 min ( T4)적평균동맥압( MAP)、심솔( HR)、호흡빈솔( RR)적변화,기록환자수술시간、술중불량반응급병발증,환자화수술의생적만의도；응용Ramsay평분평개환자적진정효과,병조사환자화골과의생적만의도。결과L조T2、T3시, HR、MAP 균명현승고( P <0．05)；여 D 조비교, L 조진정효과급의환만의도균명현강저(P<0．05)。결론우미탁미정복합서분태니응용우추간공경수술안전유효,치득재림상추엄。
Objective To evaluate the effects of dexmedetomidine combined with remifentanil for the sedation of percutaneous transforaminal endoscopy. Methods Eighty patients undergoing percutaneous transforaminal endosco-py were randomly and equally allocated into 2 groups:patients in group D (n=20) was given dexmedetomidine 1 μg/kg and remifentanil 0. 5 μg/kg followed by remifentanil 0. 05 μg/( kg·min) and dexmedetomidine 0. 5 μg /( kg·h) , patients in group L (n=20) was given local anesthesia by 1% lidocaine. The HR,MAP and RR were monitored and recorded before the anesthesia ( T0 ) ,at the time points of operation beginning ( T1 ) ,10 min after the beginning of op-eration (T2),operation termination (T3),and 30 min after operation (T4). The operation time,intraoperative and post-operative incidences of adverse reactions were recorded,the satisfactory degree was recorded too. Results The HR and MAP in group L increased significantly at T2,T3(P<0. 05). Compared with group D,the effect of sedation and the satisfactory degree in group L significantly decreased ( P <0. 05 ) . Conclusion Dexmedetomidine combined with remifentanil is safe and effective in the sedation of percutaneous transforaminal endoscopy.