实用药物与临床
實用藥物與臨床
실용약물여림상
Practical Pharmacy and Clinical Remedies
2015年
11期
1313-1317
,共5页
近日节律%右美托咪定%Ramsay镇静评分%躁动评分
近日節律%右美託咪定%Ramsay鎮靜評分%躁動評分
근일절률%우미탁미정%Ramsay진정평분%조동평분
Circadian rhythm%Dexmedetomidine%Ramsay score%Agitation score
目的 探讨近日节律对右美托咪定镇静效应的影响. 方法 选择择期行妇科手术患者48 例,年龄19~60岁,ASA Ⅰ~Ⅱ级. 随机分为上午组(9:00~11:00,M组,24 例)和下午组(14:00 ~16:00,A组,24例). 所有患者在全麻诱导前15 min静脉泵注右美托咪定0. 5 μg/kg,泵注时间为15 min. 记录两组患者用药前(T1)、拔管时(T2),拔管后1 min(T3)、拔管后5 min(T4)、拔管后10 min(T5)、拔管后30 min(T6)的HR、SBP、DBP、SpO2 及两组在用药前以及拔管期间的Ramsay镇静评分、躁动评分及回忆度评分. 记录患者拔管期间的不良反应,包括寒战、呼吸抑制、恶心、呕吐等. 用SAS 9. 13软件包进行数据处理. 结果 在T3、T4 时间点,A组患者的SBP、DBP、HR 值均明显低于M组(P<0. 05). A组患者在T3、T4、T5 时,Ramsay 镇静评分显著高于M组(P<0. 05). 在其余各时间点,两组患者Ramsay 镇静评分比较差异均无统计学意义(P>0. 05). A组患者在拔管时躁动评分显著低于M组. 两组患者围拔管期恶心、呕吐及寒战的发生率差异无统计学意义. 两组患者均未见明显的呼吸抑制. 结论 近日节律对右美托咪定的镇静作用有一定影响,下午组患者与上午组相比,右美托咪定的镇静作用较强.
目的 探討近日節律對右美託咪定鎮靜效應的影響. 方法 選擇擇期行婦科手術患者48 例,年齡19~60歲,ASA Ⅰ~Ⅱ級. 隨機分為上午組(9:00~11:00,M組,24 例)和下午組(14:00 ~16:00,A組,24例). 所有患者在全痳誘導前15 min靜脈泵註右美託咪定0. 5 μg/kg,泵註時間為15 min. 記錄兩組患者用藥前(T1)、拔管時(T2),拔管後1 min(T3)、拔管後5 min(T4)、拔管後10 min(T5)、拔管後30 min(T6)的HR、SBP、DBP、SpO2 及兩組在用藥前以及拔管期間的Ramsay鎮靜評分、躁動評分及迴憶度評分. 記錄患者拔管期間的不良反應,包括寒戰、呼吸抑製、噁心、嘔吐等. 用SAS 9. 13軟件包進行數據處理. 結果 在T3、T4 時間點,A組患者的SBP、DBP、HR 值均明顯低于M組(P<0. 05). A組患者在T3、T4、T5 時,Ramsay 鎮靜評分顯著高于M組(P<0. 05). 在其餘各時間點,兩組患者Ramsay 鎮靜評分比較差異均無統計學意義(P>0. 05). A組患者在拔管時躁動評分顯著低于M組. 兩組患者圍拔管期噁心、嘔吐及寒戰的髮生率差異無統計學意義. 兩組患者均未見明顯的呼吸抑製. 結論 近日節律對右美託咪定的鎮靜作用有一定影響,下午組患者與上午組相比,右美託咪定的鎮靜作用較彊.
목적 탐토근일절률대우미탁미정진정효응적영향. 방법 선택택기행부과수술환자48 례,년령19~60세,ASA Ⅰ~Ⅱ급. 수궤분위상오조(9:00~11:00,M조,24 례)화하오조(14:00 ~16:00,A조,24례). 소유환자재전마유도전15 min정맥빙주우미탁미정0. 5 μg/kg,빙주시간위15 min. 기록량조환자용약전(T1)、발관시(T2),발관후1 min(T3)、발관후5 min(T4)、발관후10 min(T5)、발관후30 min(T6)적HR、SBP、DBP、SpO2 급량조재용약전이급발관기간적Ramsay진정평분、조동평분급회억도평분. 기록환자발관기간적불량반응,포괄한전、호흡억제、악심、구토등. 용SAS 9. 13연건포진행수거처리. 결과 재T3、T4 시간점,A조환자적SBP、DBP、HR 치균명현저우M조(P<0. 05). A조환자재T3、T4、T5 시,Ramsay 진정평분현저고우M조(P<0. 05). 재기여각시간점,량조환자Ramsay 진정평분비교차이균무통계학의의(P>0. 05). A조환자재발관시조동평분현저저우M조. 량조환자위발관기악심、구토급한전적발생솔차이무통계학의의. 량조환자균미견명현적호흡억제. 결론 근일절률대우미탁미정적진정작용유일정영향,하오조환자여상오조상비,우미탁미정적진정작용교강.
Objective To observe the effect of circadian rhythm on the sedative effect of dexmedetomi-dine. Methods Forty-eight patients scheduled for gynecological operation under general anesthesia were assigned ran-domly into two groups. Group M(n=24) received dexmedetomidine as a dose of 0. 5 μg/kg at 15 min before induc-tion in the morning(9:00~11:00),while group A(n=24) received dexmedetomidine as a dose of 0. 5 μg/kg at 15 min before induction in the afternoon(14:00 ~16:00). HR,SBP,DBP,SpO2,Ramsay scores,agitation scores and re-call scores were recorded at the time point of pre-administration( T1 ) ,tracheal extubation( T2 ) ,1 min after tracheal ex-tubation( T3 ) ,5 min after tracheal extubation( T4 ) ,10 min after tracheal extubation( T5 ) ,30 min after tracheal extuba-tion (T6). Meanwhile,the adverse reactions including nausea,vomitting,shivering and respiratory inhibition were recor-ded. Results The SBP,DBP,HR in group A were lower than those of group M at T3 and T4(P<0. 05). The Ramsay scores in group A were higher than those of group M at T3,T4 and T5(P<0. 05),and there was no significant differ-ence in Ramsay scores between the two groups at the other time points. During tracheal extubation,the agitation scores in group A were lower than those of group M(P<0. 05). There was no significant difference in the incidence of ad-verse reactions such as nausea,vomitting and shivering between the two groups. No obvious respiratory depression was recorded. Conclusion Circadian rhythm can affect the sedative effect of dexmedetomidine,and the sedative effect of dexmedetomidine group A is stronger than that of group M.
