CAJ | 학술논문

目的：探讨鞘内注射不同剂量盐酸右美托咪定对罗哌卡因蛛网膜下腔阻滞(脊麻)效果的影响。方法择期行下肢手术患者40例,随机分为对照组和治疗组,每组20例,分别鞘内注射盐酸右美托咪定4,12μg,再缓慢注入0.75％罗哌卡因1.5 mL；记录麻醉前(t0)与注药后5,10,15,20,25,30 min 的收缩压、舒张压、心率、脉搏氧饱和度及Ramsay 评分；记录感觉、运动阻滞的起效时间和持续时间,以及恶心、呕吐、呼吸抑制等不良反应发生情况。结果治疗组和对照组感觉阻滞起效时间分别为(6.9±2.6),(8.7±2.9) min(P<0.05)；感觉阻滞持续时间分别为(130.8±20.1),(115.9±23.9) min(P<0.05)；运动阻滞持续时间分别为(145.9±29.0),(130.0±30.1) min(P<0.05)。结论盐酸右美托咪定12μg 鞘内注射可使罗哌卡因脊麻感觉阻滞起效时间增快、感觉和运动阻滞持续时间延长；并能维持血流动力学稳定,不增加恶心、呕吐、心动过缓和呼吸抑制等不良反应。
목적：탐토초내주사불동제량염산우미탁미정대라고잡인주망막하강조체(척마)효과적영향。방법택기행하지수술환자40례,수궤분위대조조화치료조,매조20례,분별초내주사염산우미탁미정4,12μg,재완만주입0.75％라고잡인1.5 mL；기록마취전(t0)여주약후5,10,15,20,25,30 min 적수축압、서장압、심솔、맥박양포화도급Ramsay 평분；기록감각、운동조체적기효시간화지속시간,이급악심、구토、호흡억제등불량반응발생정황。결과치료조화대조조감각조체기효시간분별위(6.9±2.6),(8.7±2.9) min(P<0.05)；감각조체지속시간분별위(130.8±20.1),(115.9±23.9) min(P<0.05)；운동조체지속시간분별위(145.9±29.0),(130.0±30.1) min(P<0.05)。결론염산우미탁미정12μg 초내주사가사라고잡인척마감각조체기효시간증쾌、감각화운동조체지속시간연장；병능유지혈류동역학은정,불증가악심、구토、심동과완화호흡억제등불량반응。
Objective To investigate the effects of intrathecal different doses of dexmedetomidine hydrochloride in spinal block by ropivacaine hydrochloride . Methods Forty lower limb surgery scheduled for elective under spinal anesthesia, were randomly divided into 2 groups (n = 20 each): the control and the treatment groups.The control and the treatment group were intrathecally injected with 4,12 μg dexmedetomidine hydrochloride respectively.The 0.75% ropivacaine hydrochloride 1.5 mL was injected for spinal anesthesia.SBP,DBP,HR,SpO2 and Ramsay Sedation Score were recorded before the spinal anesthesia conduct and thereafter every five minutes. And the onset and duration of block were recorded,adverse reaction like nausea, vomiting and respiratory depression were also observed. Results Compared with the control group,the onset of sensory block was shorter [(6.9±2.6) min vs (8.7±2.9) min] (P<0.05),and the duration of sensory and motor block was longer in the treatment group[(130.8±30.1) min vs (115.9±23.9) min] (P<0.05) and [(145.9±29.0) min vs (130.0±30.1) min] (P<0.05). Conclusion Intrathecal dexmedetomidine hydrochloride at 12 μg improves anesthesia via shortening the sensory block onset and prolonging sensory and motor block,which maintains hemodynamically stable,and does not generate adverse reactions as nausea,vomiting,bradycardia and respiratory depression.