四川医学
四川醫學
사천의학
Sichuan Medical Journal
2015年
10期
1389-1392
,共4页
李鹏%廖娟%郭俊%杨孟昌
李鵬%廖娟%郭俊%楊孟昌
리붕%료연%곽준%양맹창
右美托咪定%丙泊酚%镇静%门诊患者%口腔外科手术
右美託咪定%丙泊酚%鎮靜%門診患者%口腔外科手術
우미탁미정%병박분%진정%문진환자%구강외과수술
dexmedetomidine%propofol%sedation%outpatients%oral surgical procedures
目的 观察右美托咪定与丙泊酚在我院口腔门诊手术中镇静效果. 方法 在我院口腔科门诊行第三磨牙拔除或种植牙手术患者40例,随机分为两组,每组20例. 右美托咪定组(D组):负荷量2μg/(kg·h)持续泵注10min,后0. 5μg(kg·h)持续泵注;丙泊酚组(P组):丙泊酚中长链脂肪乳注射液0. 5mg/kg负荷量,静脉维持剂量4mg(kg·h)持续泵注. 连续监测患者生命体征,脑电双频指数(Bispectral index,BIS)监测镇静深度. 比较两组在局麻(T1)、牙齿拔出或备洞(T2)、缝合(T3)时患者患者Ramsay(RSS)镇静评分以及对T1~T3的记忆情况,离院前进行手术疼痛评分及患者满意度调查. 结果 D组用药后15min心率与BIS开始下降,血压下降不明显. P组用药后5min平均动脉压( Mean arterial pressure,MAP)、心率以及BIS均低于术前. BIS在用药后5、10min与D组差异有统计学意义(P<0. 05). 在T1时D组镇静评分低于P组,差异有统计学意义( P<0. 05 ). T2 时 P组有6 例评分4 分,高于 D 组,差异有统计学意义( P <0. 05). 对T1~T3记忆:D组均高于P组(P<0. 05). 两组疼痛评分及满意度未见差异. 结论 适当剂量的两药物在门诊口腔科手术中应用是安全有效的. 提前输注右美托咪定或联合应用具有顺行性遗忘的镇静药物效果可能会更满意.
目的 觀察右美託咪定與丙泊酚在我院口腔門診手術中鎮靜效果. 方法 在我院口腔科門診行第三磨牙拔除或種植牙手術患者40例,隨機分為兩組,每組20例. 右美託咪定組(D組):負荷量2μg/(kg·h)持續泵註10min,後0. 5μg(kg·h)持續泵註;丙泊酚組(P組):丙泊酚中長鏈脂肪乳註射液0. 5mg/kg負荷量,靜脈維持劑量4mg(kg·h)持續泵註. 連續鑑測患者生命體徵,腦電雙頻指數(Bispectral index,BIS)鑑測鎮靜深度. 比較兩組在跼痳(T1)、牙齒拔齣或備洞(T2)、縫閤(T3)時患者患者Ramsay(RSS)鎮靜評分以及對T1~T3的記憶情況,離院前進行手術疼痛評分及患者滿意度調查. 結果 D組用藥後15min心率與BIS開始下降,血壓下降不明顯. P組用藥後5min平均動脈壓( Mean arterial pressure,MAP)、心率以及BIS均低于術前. BIS在用藥後5、10min與D組差異有統計學意義(P<0. 05). 在T1時D組鎮靜評分低于P組,差異有統計學意義( P<0. 05 ). T2 時 P組有6 例評分4 分,高于 D 組,差異有統計學意義( P <0. 05). 對T1~T3記憶:D組均高于P組(P<0. 05). 兩組疼痛評分及滿意度未見差異. 結論 適噹劑量的兩藥物在門診口腔科手術中應用是安全有效的. 提前輸註右美託咪定或聯閤應用具有順行性遺忘的鎮靜藥物效果可能會更滿意.
목적 관찰우미탁미정여병박분재아원구강문진수술중진정효과. 방법 재아원구강과문진행제삼마아발제혹충식아수술환자40례,수궤분위량조,매조20례. 우미탁미정조(D조):부하량2μg/(kg·h)지속빙주10min,후0. 5μg(kg·h)지속빙주;병박분조(P조):병박분중장련지방유주사액0. 5mg/kg부하량,정맥유지제량4mg(kg·h)지속빙주. 련속감측환자생명체정,뇌전쌍빈지수(Bispectral index,BIS)감측진정심도. 비교량조재국마(T1)、아치발출혹비동(T2)、봉합(T3)시환자환자Ramsay(RSS)진정평분이급대T1~T3적기억정황,리원전진행수술동통평분급환자만의도조사. 결과 D조용약후15min심솔여BIS개시하강,혈압하강불명현. P조용약후5min평균동맥압( Mean arterial pressure,MAP)、심솔이급BIS균저우술전. BIS재용약후5、10min여D조차이유통계학의의(P<0. 05). 재T1시D조진정평분저우P조,차이유통계학의의( P<0. 05 ). T2 시 P조유6 례평분4 분,고우 D 조,차이유통계학의의( P <0. 05). 대T1~T3기억:D조균고우P조(P<0. 05). 량조동통평분급만의도미견차이. 결론 괄당제량적량약물재문진구강과수술중응용시안전유효적. 제전수주우미탁미정혹연합응용구유순행성유망적진정약물효과가능회경만의.
Objective To review the sedation effection of dexmedetomidine and propofol in oral outpatient surgery. Meth-od Fourty patients undergoing oral outpatient surgery were selected and divided into two groups(20 in each). In group D,dexme-detomidine was preloaded in dose of 2 μg/( kg·h) for 10 minutes and maintained with a dosage of 0. 5μg/( kg·h) . In groupP, propofol was preloaded in dose of 0. 5mg/kg and manintained with 4mg/(kg·h). The vital signs and bispectralindex(BIS)were measured continuously. Ramsay sedation scores(RSS)were assessed during infiltration anesthesia(T1), remove the tooth or cutting (T2)and suturing(T3). Before departure from the hospital, patients were asked whether they remember the procedure of T1 to T3. The visual analogue scale(VAS)and the degree of patient satisfaction were assessed at the same time. Results Ingroup D, 15minutes later the HR and BIS began to decrease but blood pressure decline was not obvioused. In group P,five minutes after the injection, mean arterial pressure( MAP) , HR and BIS were lower than the intraoperative. Five and ten minutes after the medica-tion,BIS in group P were significantly lower than group D(P<0. 05). At T1, in group D, the RSS scores were lower than group P(P<0. 05). At T2,there were six cases with the scores of four in group P which was more than group D. For the memories of T1 to T3, more patients could remember in group D than P. The VAS scores and satisfaction in both group had no difference. Con-clusion A appropriate dose of two drugs in outpatient dental surgery is safe and effective. Earler administration of dexmedetomi-dine or combine with a sedative drug which have a effection of anterograde amnesia might be more satisfied.
