本文關(guān)鍵詞：右美托咪定對(duì)老年重癥患者術(shù)后譫妄的影響，由筆耕文化傳播整理發(fā)布。

右美托咪定對(duì)老年重癥患者術(shù)后譫妄的影響

The effect of dexmedetomidine on the incidence of postoperative delirium in critically ill elderly patients

[1] [2] [3]

YAO Yue-Qin, WANG Dong-Xin, SHI Cheng-Mei. Department of Anesthesiology, First Hospital, Peking University, Beijing 100034, China

北京大學(xué)第一醫(yī)院麻醉科,100034

文章摘要：目的觀察右美托咪定老年重癥患者術(shù)后譫妄發(fā)生的影響。方法60例行擇期硬膜外復(fù)合全麻下腹部手術(shù)術(shù)后入SICU患者，年齡≥65歲。隨機(jī)均分為治療組和對(duì)照組，治療組持續(xù)靜脈輸注右美托咪定0．2μg·kg^-1·h^-1直至總劑量達(dá)200μg（用生理鹽水稀釋至50ml），，；對(duì)照組給予等容量生理鹽水。觀察術(shù)后第1、2、3天靜息和咳嗽時(shí)VAS疼痛評(píng)分和睡眠評(píng)分，術(shù)后6、12h、停藥時(shí)、術(shù)后24、48h鎮(zhèn)痛泵的按壓次數(shù)和用藥量情況及術(shù)后7d內(nèi)譫妄發(fā)生率。結(jié)果兩組低血壓發(fā)生率、VAS疼痛評(píng)分差異無統(tǒng)計(jì)學(xué)意義。術(shù)后第1天睡眠評(píng)分治療組（3．48±2．19）分，明顯低于對(duì)照組的（4．67±2．44）分（P〈0．05）。術(shù)后7d內(nèi)對(duì)照組譫妄發(fā)生率9例（31．0％），治療組13例（44．8％），兩組差異無統(tǒng)計(jì)學(xué)意義。結(jié)論老年外科重癥患者，持續(xù)靜脈輸注右美托咪定0．2μg·k-1·h^-1能改善睡眠質(zhì)量，對(duì)術(shù)后鎮(zhèn)痛及譫妄發(fā)生無明顯影響。

Abstr：Objective To evaluate the effect of dexmedetomidine on the incidence of postoperative delirium in critically ill elderly patients. Methods Sixty patients who were 65 years or older, having underwent intra-abdominal surgery under combined epidural-general anesthesia were randomly divided into two groups. In treatment group, dexmedetomidine was administrated as an intravenous infusion at the rate of 0.2μg· kg-1 ·h-1 until the total dose of 200 μg. In the control group, normal saline was given. The visual analogue scores （VAS） of pain at rest and on coughing, VAS score of sleep, as well as the times of demands and the total consumption of PCEA were recorded. The occurrence of postoperative delirium was evaluated regularly until the seventh postoperative day. Results The incidence of hypotension was slightly higher in treatment group than in control group （P《0.05）. There were no significant differences between two groups in the VAS pain scores, the total demand times, effective demand times and the total drug consumption of PCEA. The VAS score of sleep was significantly lower in treatment group than in control group on the first postoperative day [（3.48 ± 2.19） vs. （4.67 ± 2.44）, P〈 0.05]. There were no significant differences between two groups in postoperative dolirium of nine cases （31.0%） in control group and in 13 cases （44. 8%） in treatment group. Conclusion In the critically ill elderly patients, continuous intravenous infusion of dexmedetomidine at the rate of 0. 2 μg· kg-1 ·h-1 may improve sleep quality, had no significant influence on the analgesic effects of PCEA and on the incidence of postoperative deliriurn.

文章關(guān)鍵詞：

Keyword：:Dexmedetomidine Elderly critically ill patient Postoperative delirium

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  本文關(guān)鍵詞：右美托咪定對(duì)老年重癥患者術(shù)后譫妄的影響，由筆耕文化傳播整理發(fā)布。