本文選題：右美托咪定 + 高原地區(qū)　； 參考：《高原醫(yī)學(xué)雜志》2016年02期

【摘要】：目的:觀察小劑量右美托咪定對高原地區(qū)老年肺心病患者椎管內(nèi)麻醉術(shù)中鎮(zhèn)靜的臨床應(yīng)用。方法:擇期行下肢骨科手術(shù)老年肺心病患者30例,行連硬外麻醉,將患者按隨機(jī)數(shù)字分為右美托咪定組(DEX組)和生理鹽水組(對照組)各15例,記錄患者麻醉后,給予DEX即時(shí)、給藥10min、20min、30min、60min及術(shù)畢時(shí)的血壓、心率、呼吸頻率、SpO_2、PETCO_2,BIS值及鎮(zhèn)靜/警覺(OAA/S)評(píng)分。結(jié)果:兩組患者的心率、呼吸頻率、SpO_2及PETCO_2在組間和組內(nèi)比較均無明顯改變;DEX組患者的SBP、DBP及MAP與給藥即時(shí)比較明顯降低(P0.05),降低幅度為給藥即時(shí)的10%~15%,對照組患者血壓無明顯改變;DEX組給藥后各時(shí)間點(diǎn)產(chǎn)生明顯鎮(zhèn)靜效應(yīng),明顯低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:小劑量右美托咪定靜脈連續(xù)輸注可對老年患者產(chǎn)生明顯鎮(zhèn)靜、抗交感及抗焦慮作用,無明顯的循環(huán)呼吸抑制,鎮(zhèn)靜后的患者易合作,特別適合術(shù)前合并缺氧心肺功能改變的高原地區(qū)的高齡患者。
[Abstract]:Objective: to observe the clinical application of low dose dexmetomidine in spinal canal anesthesia in elderly patients with cor pulmonale at high altitude. Methods: thirty elderly patients with cor pulmonale undergoing orthopaedic surgery of lower extremities were randomly divided into two groups: dexmetomidine group (n = 15) and saline group (n = 15). After anesthesia, patients were given DEX immediately. Blood pressure, heart rate, respiratory frequency, SpO2PETCO2BIS and OAA / S score at the end of operation. Results: heart rate of the two groups, Respiratory frequency SpO2 and PETCO_2 were not significantly changed in both groups and within groups. SBPnDBP and MAP in DEX group were significantly lower than those in the immediate treatment group, and decreased by 10% and 1515% respectively. There was no significant change in blood pressure in the control group after the drug was given to the patients in the DEX group each time after administration of the drug, there was no significant change in the blood pressure of the patients in the control group. The time point has a significant sedative effect, The difference was significantly lower than that of the control group (P 0.05). Conclusion: continuous intravenous infusion of low-dose dexmetomidine can induce sedation, anti-sympathetic and anti-anxiety effects in elderly patients. There is no obvious circulatory respiratory inhibition, and the patients after sedation are easy to cooperate. It is especially suitable for the elderly patients with hypoxic cardiopulmonary function changes at high altitude before operation.
【作者單位】： 青海省交通醫(yī)院麻醉科;
【分類號(hào)】：R614
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本文編號(hào)：1794129