本文選題：右美托咪定 + 高齡�。� 參考：《重慶醫(yī)學(xué)》2017年20期

【摘要】：目的觀察右美托咪啶(Dex)對(duì)硬膜外麻醉患者的鎮(zhèn)靜效應(yīng)及其對(duì)呼吸循環(huán)的影響。方法選擇180例下肢手術(shù)患者,行硬膜外麻醉,麻醉效果測(cè)試滿意后,用微量泵泵注Dex。分為D1、D2、D3組,每組60例。D1組Dex負(fù)荷量0.2μg/kg,10min內(nèi)泵完,然后以0.1μg·kg~(-1)·h~(-1)維持輸注;D2組Dex負(fù)荷量0.5μg/kg,10min內(nèi)泵完,然后以0.2μg·kg~(-1)·h~(-1)維持輸注;D3組為對(duì)照,泵注等量生理鹽水。記錄給藥前(T0)、輸注負(fù)荷量結(jié)束即刻(T1)、輸注維持量5min(T2),輸注維持量10min(T3)、輸注維持量30min(T4)、停止輸注后10min(T5)、停止輸注后30min(T6)時(shí)的腦電雙頻譜指數(shù)(BIS)、平均動(dòng)脈壓(MAP)、心率(HR)、呼吸(RR)、血氧飽和度(SpO_2),并對(duì)患者進(jìn)行Ramsay鎮(zhèn)靜評(píng)分。結(jié)果 T1~T6時(shí)點(diǎn)D1組患者的MAP、SpO_2、RR與其他組相比差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。D1組患者的HR與D2組相比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。D1、D2組BIS、Ramsay值與D3組相比差異有統(tǒng)計(jì)學(xué)意義(P0.05)。D2組心動(dòng)過(guò)緩發(fā)生率95%,有23例經(jīng)阿托品對(duì)癥處理或暫停輸注DEX,而D1組心動(dòng)過(guò)緩有15%,且程度較輕,經(jīng)暫停輸注DEX好轉(zhuǎn),僅有2例給予阿托品處理。結(jié)論小劑量Dex用于高齡(70歲以上)患者硬膜外麻醉期間有良好鎮(zhèn)靜效果,且心率更穩(wěn)定,安全性更高。
[Abstract]:Objective to observe the sedation effect of dexmetidine on epidural anesthesia and its effect on respiration and circulation. Methods 180 patients undergoing lower extremity operation were treated with epidural anesthesia. Each group was divided into two groups: group D _ (1) D _ (2) D _ (2) D _ (3), each group (n = 60) with Dex loading 0.2 渭 g / kg ~ (-1) within 10 minutes, and then with 0.1 渭 g 路kg ~ (-1) 路h ~ (-1) 路h ~ (-1) Dex in D _ 2 group within 10 minutes, then 0.2 渭 g 路kg ~ (-1) h ~ (-1) Dex was administered to D3 group as control group, and the same amount of normal saline was injected into D _ (3) group. The bispectral index of BISI, mean arterial pressure MAPP, heart rate, respiratory RRR, blood oxygen were recorded before administration of T0, T0, T1, T1, T2, T3, T3, T5, T5 and T6, respectively, at 10 min after infusion and 30 min after T6), mean arterial pressure MAPP, heart rate, respiratory RRR, and blood oxygenation at the end of the infusion period (T0, T0, T1, T1, T2, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T6). The patients were treated with Ramsay sedation score. Results there was no significant difference between T1~T6 and other groups. HR of group D1 was significantly different from that of group D2. There was a significant difference in bradycardia between group D _ 2 and group D _ 3 compared with group D _ 3. There was a significant difference in bradycardia between group D _ 2 and group D _ 3. The birth rate was 95%, 23 cases were treated with atropine or stopped infusion of DEX, while 15 cases of bradycardia in group D1 were mild, After suspension of DEX, only 2 cases were treated with atropine. Conclusion low dose Dex has good sedation effect during epidural anesthesia in elderly patients over 70 years old, and the heart rate is more stable and safe.
【作者單位】： 重慶市榮昌區(qū)人民醫(yī)院麻醉科;
【分類號(hào)】：R614

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本文編號(hào)：1877874