实用药物与临床
實用藥物與臨床
실용약물여림상
Practical Pharmacy and Clinical Remedies
2015年
11期
1389-1392
,共4页
曹小飞%丁正年%陈惠裕%陆蕴红
曹小飛%丁正年%陳惠裕%陸蘊紅
조소비%정정년%진혜유%륙온홍
氯胺酮%瑞芬太尼%右美托咪定%ERCP
氯胺酮%瑞芬太尼%右美託咪定%ERCP
록알동%서분태니%우미탁미정%ERCP
Ketamine%Remifentanil%Dexmedetomidine%Endoscopic retrograde cholangiopancreatography
目的 探讨小剂量氯胺酮复合右美托咪定在老年人治疗性内镜逆行胰胆管造影术( ERCP)的应用效果. 方法 选择100例行ERCP的患者,采用随机数字表法,将其分为2 组,每组50 例:氯胺酮+右美托咪定组( KD组)和瑞芬太尼+右美托咪定组( RD组). 两组患者均于手术前10 min静脉推注右美托咪定1 μg/kg,然后持续泵注右美托咪定0. 5 μg/( kg·h). 于手术开始时,KD组静脉推注0. 4 mg/kg氯胺酮,然后持续泵注氯胺酮5 μg/( kg·min);RD组静脉推注瑞芬太尼0. 5 μg/kg,随后持续输注瑞芬太尼0. 05 μg/( kg·h). 并记录给药前(T0)、手术开始时(T1)、手术开始后30 min(T2)、术毕时(T3)的平均动脉压(MAP)、心率(HR)、呼吸( RR)、脉搏氧饱和度( SpO2 )的变化;用Ramsay镇静评分来评价患者的镇静效果;记录手术时间、术中术后不良反应发生率及患者、麻醉医生和手术医生的满意度等. 结果 与T0 时相比,RD组患者T1 时HR、BP明显升高(P<0. 05);与RD组相比,KD组术后患者满意度明显增高(P<0. 05),且镇静满意的比例明显增高(P<0. 05).结论 小剂量氯胺酮复合右美托咪定用于ERCP中,可获得更满意的镇痛、镇静效果,且更安全.
目的 探討小劑量氯胺酮複閤右美託咪定在老年人治療性內鏡逆行胰膽管造影術( ERCP)的應用效果. 方法 選擇100例行ERCP的患者,採用隨機數字錶法,將其分為2 組,每組50 例:氯胺酮+右美託咪定組( KD組)和瑞芬太尼+右美託咪定組( RD組). 兩組患者均于手術前10 min靜脈推註右美託咪定1 μg/kg,然後持續泵註右美託咪定0. 5 μg/( kg·h). 于手術開始時,KD組靜脈推註0. 4 mg/kg氯胺酮,然後持續泵註氯胺酮5 μg/( kg·min);RD組靜脈推註瑞芬太尼0. 5 μg/kg,隨後持續輸註瑞芬太尼0. 05 μg/( kg·h). 併記錄給藥前(T0)、手術開始時(T1)、手術開始後30 min(T2)、術畢時(T3)的平均動脈壓(MAP)、心率(HR)、呼吸( RR)、脈搏氧飽和度( SpO2 )的變化;用Ramsay鎮靜評分來評價患者的鎮靜效果;記錄手術時間、術中術後不良反應髮生率及患者、痳醉醫生和手術醫生的滿意度等. 結果 與T0 時相比,RD組患者T1 時HR、BP明顯升高(P<0. 05);與RD組相比,KD組術後患者滿意度明顯增高(P<0. 05),且鎮靜滿意的比例明顯增高(P<0. 05).結論 小劑量氯胺酮複閤右美託咪定用于ERCP中,可穫得更滿意的鎮痛、鎮靜效果,且更安全.
목적 탐토소제량록알동복합우미탁미정재노년인치료성내경역행이담관조영술( ERCP)적응용효과. 방법 선택100례행ERCP적환자,채용수궤수자표법,장기분위2 조,매조50 례:록알동+우미탁미정조( KD조)화서분태니+우미탁미정조( RD조). 량조환자균우수술전10 min정맥추주우미탁미정1 μg/kg,연후지속빙주우미탁미정0. 5 μg/( kg·h). 우수술개시시,KD조정맥추주0. 4 mg/kg록알동,연후지속빙주록알동5 μg/( kg·min);RD조정맥추주서분태니0. 5 μg/kg,수후지속수주서분태니0. 05 μg/( kg·h). 병기록급약전(T0)、수술개시시(T1)、수술개시후30 min(T2)、술필시(T3)적평균동맥압(MAP)、심솔(HR)、호흡( RR)、맥박양포화도( SpO2 )적변화;용Ramsay진정평분래평개환자적진정효과;기록수술시간、술중술후불량반응발생솔급환자、마취의생화수술의생적만의도등. 결과 여T0 시상비,RD조환자T1 시HR、BP명현승고(P<0. 05);여RD조상비,KD조술후환자만의도명현증고(P<0. 05),차진정만의적비례명현증고(P<0. 05).결론 소제량록알동복합우미탁미정용우ERCP중,가획득경만의적진통、진정효과,차경안전.
Objective To explore the effects of small dose of ketamine combined with dexmedetomidine for the endoscopic retrograde cholangiopancreatography ( ERCP) in the elderly patients. Methods One hundred patients undergoing ERCP were randomly and equally allocated into group KD (n=50) and group RD(n=50). Two groups received dexmedetomidine continuous infusion at the speed of 0. 5 μg/( kg·h) followed by 1 μg/kg intravenous injec-ton at 10 min before operation. Patients in group KD received ketamine 0. 4 mg/kg intravenous injection and 5 μg/( kg·min) continous infusion;Patients in group RD received remifentanil 0. 5 μg/kg intravenous injection and 0. 05μg/( kg·min) continous infusion. HR,MAP,SpO2 and RR were monitored and recorded before the anesthesia( T0 ) ,at the time points of operation beginning( T1 ) ,30 min after operation beginning( T2 ) ,at the time point of operation termi-nation (T3). Sedation effects of the patient were evaluated by Ramsay scores. The operation time,intraoperative and postoperative incidence of adverse reactions were recorded. The satisfaction of patient,anesthesiologist and surgeon were recorded too. Results In group RD,compared with T0,HR,MAP in T1 increased significantly(P<0. 05). Compared with group RD,the satisfaction of patient and sedation effect increased significantly in group KD (P<0. 05). Conclu-sion Small dose of ketamine combined with dexmedetomidine has better effect of sedation than that of the combina-tion of remifentanil and dexmedetomidine with higher safety.
