中外健康文摘
中外健康文摘
중외건강문적
WORLD HEALTH DIGEST
2014年
11期
85-86
,共2页
右美托咪定%老年腰-硬联合麻醉%镇静效果
右美託咪定%老年腰-硬聯閤痳醉%鎮靜效果
우미탁미정%노년요-경연합마취%진정효과
Dexmedetomidine%Combined Spinal Epidural Anesthesia (CSEA)%Sedative effect
目的:观察右美托咪定对老年腰-硬联合麻醉的镇静效果。方法:将来我院就诊的ASAⅡ级或ASAⅢ级拟行腰-硬联合麻醉的患者120例作为研究对象,随机分为空白对照组(A组)、丙泊酚组(B组)和右美托咪定组(C1、C2、C3组)。记录患者麻醉前(T1)、腰-硬联合麻醉后(T2)、用药后5min(T3)、15min(T4)、30min(T5)、60min(T6)的HR、MAP、SpO2、RR和Ramsay评分,手术后24h对患者进行随访,询问患者用药后到手术结束前对于有关操作的遗忘程度。结果:用药后5min开始,右美托咪定组所有患者和丙泊酚组患者(B组)的Ramsay评分比麻醉前要高(P<0.05),用药后T4-T6,右美托咪定组中C2、C3以及B组明显高于A组(P<0.05)。用药后T5、T6使B组的MAP比其他组低(P<0.05)。T4、T5、T6时D3组的HR比其他组慢(P<0.05)。术后24h随访患者,右美托咪定组顺行性遗忘程度比空白对照组高(P<0.05),和丙泊酚组(B组)差异无统计学意义。结论:对老年腰-硬联合麻醉患者静脉注射右美托咪定0.5μg/kg后再输注0.2-0.5μg囯kg-1?h-1镇静效果更好。
目的:觀察右美託咪定對老年腰-硬聯閤痳醉的鎮靜效果。方法:將來我院就診的ASAⅡ級或ASAⅢ級擬行腰-硬聯閤痳醉的患者120例作為研究對象,隨機分為空白對照組(A組)、丙泊酚組(B組)和右美託咪定組(C1、C2、C3組)。記錄患者痳醉前(T1)、腰-硬聯閤痳醉後(T2)、用藥後5min(T3)、15min(T4)、30min(T5)、60min(T6)的HR、MAP、SpO2、RR和Ramsay評分,手術後24h對患者進行隨訪,詢問患者用藥後到手術結束前對于有關操作的遺忘程度。結果:用藥後5min開始,右美託咪定組所有患者和丙泊酚組患者(B組)的Ramsay評分比痳醉前要高(P<0.05),用藥後T4-T6,右美託咪定組中C2、C3以及B組明顯高于A組(P<0.05)。用藥後T5、T6使B組的MAP比其他組低(P<0.05)。T4、T5、T6時D3組的HR比其他組慢(P<0.05)。術後24h隨訪患者,右美託咪定組順行性遺忘程度比空白對照組高(P<0.05),和丙泊酚組(B組)差異無統計學意義。結論:對老年腰-硬聯閤痳醉患者靜脈註射右美託咪定0.5μg/kg後再輸註0.2-0.5μg囯kg-1?h-1鎮靜效果更好。
목적:관찰우미탁미정대노년요-경연합마취적진정효과。방법:장래아원취진적ASAⅡ급혹ASAⅢ급의행요-경연합마취적환자120례작위연구대상,수궤분위공백대조조(A조)、병박분조(B조)화우미탁미정조(C1、C2、C3조)。기록환자마취전(T1)、요-경연합마취후(T2)、용약후5min(T3)、15min(T4)、30min(T5)、60min(T6)적HR、MAP、SpO2、RR화Ramsay평분,수술후24h대환자진행수방,순문환자용약후도수술결속전대우유관조작적유망정도。결과:용약후5min개시,우미탁미정조소유환자화병박분조환자(B조)적Ramsay평분비마취전요고(P<0.05),용약후T4-T6,우미탁미정조중C2、C3이급B조명현고우A조(P<0.05)。용약후T5、T6사B조적MAP비기타조저(P<0.05)。T4、T5、T6시D3조적HR비기타조만(P<0.05)。술후24h수방환자,우미탁미정조순행성유망정도비공백대조조고(P<0.05),화병박분조(B조)차이무통계학의의。결론:대노년요-경연합마취환자정맥주사우미탁미정0.5μg/kg후재수주0.2-0.5μg국kg-1?h-1진정효과경호。
Objective: To observe the sedative effect of dexmedetomidine in aged patients with combined spinal epidural anesthesia (CSEA). Methods:120 patients, ASA Ⅱo r ASAⅢ, scheduled for with CSEA, were equal y randomized into five groups: control group (group A), propofol group (group B) and dexmedetomidine group (C1, C2, C3 groups), and MAP, HR, RR, SpO2 and Ramsay score were recorded before anesthesia, after CSEA, and 5, 15, 30 and 60 min after sedative administration, Al patients were fol owed up 24 h postoperatively to observe the amnestic effect during operation. Results: Ramsay scores were higher in C1, C2, C3, B groups at T3-T6 than at T1 (P<0.05) . Ramsay scores were higher in C2,C3, B groups than A group at T4-T6 (P<0.05) . HR decreased in C3 group than other grous at T4-T6 ( P<0.05) . MAP decreased in B group than other groups at T5 and T6 (P<0.05). Amnestic effects in dexmedetomidine groups were higher comparing to A group (P<0.05), while had no difference comparing to B group. Conclusion: Dexmedetomidine 0.5μg/kg fol owed by 0.2-0.5μg?kg-1?h-1intravenous infusion caused effective sedation and amnestic effect during operation for aged patients with CSEA with no respiratory depression and cycle inhibition.