本文選題：右美托咪定 + 瑞芬太尼��； 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探索右美托咪定復(fù)合瑞芬太尼在中期妊娠患者引產(chǎn)術(shù)鎮(zhèn)靜的最小有效劑量,旨在為右美托咪定在中期妊娠引產(chǎn)術(shù)中的應(yīng)用提供合理依據(jù),以確保產(chǎn)婦在引產(chǎn)過(guò)程中的安全性。方法:選擇年齡18-45歲,ASA I或II級(jí)的產(chǎn)婦參加本實(shí)驗(yàn)。當(dāng)產(chǎn)婦進(jìn)入產(chǎn)房后,常規(guī)監(jiān)測(cè)心率、無(wú)創(chuàng)血壓、脈搏血氧飽和度、呼吸頻率、BIS值。對(duì)所有產(chǎn)婦給予面罩持續(xù)吸氧(氧流量2-3L/min),開(kāi)放上肢靜脈通道。給予瑞芬太尼負(fù)荷劑量0.5μg/kg,持續(xù)泵注劑量0.05μg/kg/min,同時(shí)泵注右美托咪定,初始劑量0.2μg/kg/h,給藥后26分鐘評(píng)估產(chǎn)婦的鎮(zhèn)靜深度,通過(guò)改良序貫法來(lái)確定右美托咪定的劑量,若上一例產(chǎn)婦意識(shí)抑制陽(yáng)性,則下一例產(chǎn)婦藥物劑量減少0.05μg/kg/h,反之增加0.05μg/kg/h,直至研究結(jié)果出現(xiàn)7個(gè)意識(shí)抑制陰性轉(zhuǎn)陽(yáng)性的轉(zhuǎn)折點(diǎn),研究結(jié)束。意識(shí)抑制陽(yáng)性定義為:睫毛反應(yīng)消失,Ramsay評(píng)分4級(jí),BIS值≤70。結(jié)果:共有26例產(chǎn)婦參加研究,右美托咪定用于中期妊娠引產(chǎn)患者出現(xiàn)意識(shí)抑的ED50、ED95及其95%CI分別為0.39μg/kg/h(0.32~0.61μg/kg/h)、0.62μg/kg/h(0.48~1.95μg/kg/h)。結(jié)論:右美托咪定復(fù)合瑞芬太尼用于中期妊娠引產(chǎn)術(shù)患者鎮(zhèn)靜的半數(shù)有效劑量為0.39μg/kg/h。
[Abstract]:Objective: to explore the minimum effective dose of dexmetomidine combined with remifentanil in the sedation of induced labor in the second trimester of pregnancy, so as to provide a reasonable basis for the application of dexmetomidine in the induction of labor in the second trimester. To ensure the safety of pregnant women during induction of labor. Methods: women aged 18-45 years with ASA I or II were enrolled in this study. Heart rate, noninvasive blood pressure, pulse oxygen saturation, respiratory frequency and BIS value were routinely monitored when the parturient entered the labor room. All parturients were given continuous oxygen inhalation (oxygen flow rate 2-3 L / min), opening of upper limb venous passage. The loading dose of remifentanil was 0.5 渭 g / kg, the continuous dose was 0.05 渭 g / kg / min, and the initial dose was 0.2 渭 g / kg / h. 26 minutes after administration, the depth of sedation was evaluated, and the dose of dexmetomidine was determined by the modified sequential method. If the last case was positive for consciousness inhibition, the next case had a decrease in drug dose of 0.05 渭 g / kg / h, whereas an increase of 0.05 渭 g / kg / h, until the results of the study showed 7 turning points of negative to positive of consciousness inhibition. Consciousness inhibition positive is defined as: eyelash response disappeared and Ramsay score grade 4 and BIS 鈮，

本文編號(hào)：1972263