本文選題：腰椎　切入點(diǎn)：麻醉　出處：《中國組織工程研究》2015年11期 　論文類型：期刊論文

【摘要】：背景:目前臨床常用的麻醉藥對(duì)老年患者圍手術(shù)期的血流動(dòng)力學(xué)和認(rèn)知功能均產(chǎn)生一定的影響,有研究報(bào)道右旋美托咪啶對(duì)腎上腺素能受體具有高親和力,可能對(duì)血流動(dòng)力學(xué)影響甚小。目的:觀察采用右美托咪定對(duì)老年腰椎手術(shù)麻醉血流動(dòng)力學(xué)及認(rèn)知功能的影響。方法:選擇腰椎手術(shù)的60歲以上美國麻醉醫(yī)師協(xié)會(huì)(ASA)Ⅰ-Ⅱ級(jí)擬行擇期腰椎手術(shù)患者90例,隨機(jī)分為3組,每組患者30例。0.5μg組、1.0μg組患者均于麻醉誘導(dǎo)后按照右美托咪定1.0μg/kg給予負(fù)荷劑量,輸注15 min,然后分別按照0.5μg、1.0μg持續(xù)泵入,對(duì)照組給予等量生理鹽水。3組患者的麻醉誘導(dǎo)均采用咪唑安定0.04 mg/kg+芬太尼5μg/kg+維酷溴銨0.1 mg/kg。比較3組患者的鎮(zhèn)靜評(píng)估及遺忘程度、全麻插管期血流動(dòng)力學(xué)穩(wěn)定性、術(shù)后認(rèn)知功能的差異。結(jié)果與結(jié)論:用藥后5,10 min的聽覺誘發(fā)電位指數(shù)3組間差異有顯著性意義(P0.05),1.0μg組顯著低于0.5μg組和對(duì)照組(P0.05),0.5μg組顯著低于對(duì)照組(P0.05)。用藥10 min后1.0μg組患者改良警覺/鎮(zhèn)靜視覺評(píng)分顯著低于0.5μg組和對(duì)照組(P0.05)。1.0μg組、0.5μg組5,10,20,30,60 min時(shí)刻的收縮壓均顯著高于對(duì)照組,給藥后各時(shí)間點(diǎn)舒張壓均顯著高于對(duì)照組(P0.05)。1.0μg組的術(shù)后認(rèn)知功能障礙發(fā)生率顯著低于0.5μg組和對(duì)照組(P0.05)。結(jié)果提示全麻鎮(zhèn)痛中采用右美托咪定有利于患者術(shù)中血流動(dòng)力學(xué)穩(wěn)定,降低術(shù)后認(rèn)知障礙的發(fā)生。
[Abstract]:Background: at present, the perioperative period in elderly patients with hemodynamic and cognitive function in clinical commonly used anesthetics may have certain effect, there are reports of dexmedetomidine on adrenergic receptors with high affinity, may affect the hemodynamics is very small. Objective: To observe the effect of using dexmedetomidine anesthesia blood flow dynamics and cognitive function the elderly lumbar surgery. Methods: lumbar surgery over the age of 60 American Society of anesthesiologists (ASA) grade to 90 patients who underwent elective lumbar surgery, were randomly divided into 3 groups, each group of 30 cases of patients with.0.5 G group, 1 g group of patients after induction of anesthesia with dexmedetomidine 1 g/kg loading dose, infusion of 15 min, and then according to the 0.5 g, 1 g continuous infusion, the control group was given normal saline.3 group anesthesia induced with midazolam 0.04 mg/kg+ fentanyl 5 g/kg+ dimension 閰鋒捍閾，

本文編號(hào)：1612950