CAJ | 학술논문

目的：探讨不同剂量右美托咪定对颈丛阻滞下老年锁骨手术患者呼吸及循环的影响。方法选择解放军白求恩国际和平医院2012年6月—2014年12月行锁骨手术的老年患者40例,随机分为L和H组,每组20例。颈丛阻滞完成后,L组、H组分别静脉泵注右美托咪定0.5、1.0μg/kg,两组均在15 min内注射完毕。观察记录两组在右美托咪定泵注前(T0)、泵注结束(T1)、切皮即刻(T2)、锁骨探查(T3)和手术结束(T4)时收缩压(SBP)、舒张压( DBP)、心率( HR)、呼吸( R)、脉搏氧饱和度( SpO2)的变化,观察两组窦性心动过缓发生情况。结果 L组和H组在T1~3时SBP、DBP和HR低于T0时(P<0．05)；H组T1~3时HR低于L组(P<0．05)。 L组窦性心动过缓发生率显著低于H组(P<0．05)。结论右美托咪定在老年锁骨手术患者颈丛阻滞中辅助镇静镇痛效果满意,0.5 μg/kg术前静注对呼吸循环影响小、安全可靠。
목적：탐토불동제량우미탁미정대경총조체하노년쇄골수술환자호흡급순배적영향。방법선택해방군백구은국제화평의원2012년6월—2014년12월행쇄골수술적노년환자40례,수궤분위L화H조,매조20례。경총조체완성후,L조、H조분별정맥빙주우미탁미정0.5、1.0μg/kg,량조균재15 min내주사완필。관찰기록량조재우미탁미정빙주전(T0)、빙주결속(T1)、절피즉각(T2)、쇄골탐사(T3)화수술결속(T4)시수축압(SBP)、서장압( DBP)、심솔( HR)、호흡( R)、맥박양포화도( SpO2)적변화,관찰량조두성심동과완발생정황。결과 L조화H조재T1~3시SBP、DBP화HR저우T0시(P<0．05)；H조T1~3시HR저우L조(P<0．05)。 L조두성심동과완발생솔현저저우H조(P<0．05)。결론우미탁미정재노년쇄골수술환자경총조체중보조진정진통효과만의,0.5 μg/kg술전정주대호흡순배영향소、안전가고。
Objective To investigate the effects of different dosages of Dexmedetomidine on respiratory and cir-culatory systems of elderly patients with cervical plexus block during clavicle operation. Methods A total of 40 elderly patients undergoing clavicle operation during June 2012 and December 2014 were randomly divided into group L (n=20) and group H (n=20). After cervical plexus block was completed, 0. 5μg/kg and 1. 0μg/kg Dexmedetomidine were re-spectively injected for group L and group H via venous pump within 15 min. The changes of systolic blood pressure ( SBP) , diastolic blood pressure ( DBP) , heart rate ( HR) , respiration ( R) and arterial oxygen saturation( SpO2 ) were observed and recorded before infusion ( T0 ) , at the end of infusion ( T1 ) , at the time of skin incision ( T2 ) , while see-king clavicle ( T3 ) and at the end of surgery ( T4 ) in the two groups, and at the incidence rates of sinus bradycardia in the two groups were also observed. Results Levels of SBP, DBP and HR in T1-3 were significantly lower than those at T0 in group L and H (P<0. 05);HR levels in T1-3 in group H were significantly lower than those in group L (P<0. 05). The incidence rate of sinus tachycardia in group L was significantly lower than that in group H (P<0. 05). Conclusion Dexmedetomidine assisted with cervical plexus block in sedation and analgesia for elderly patients during clavicle sur-gery has good effect, and preoperative intravenous infusion with 0. 5μg/kg Dexmedetomidine has little effect on respirato-ry and circulatory systems with good safety.