本文選題：老年人　切入點：右美托咪定　出處：《中國新藥與臨床雜志》2017年05期

【摘要】：目的觀察右美托咪定用于老年患者脊椎-硬膜外麻醉輔助鎮(zhèn)靜時腦電雙頻指數(shù)(BIS)與Ramsay鎮(zhèn)靜評分(RSS)的相關(guān)性。方法選取擬行膝關(guān)節(jié)置換術(shù)患者120例,均行脊椎-硬膜外麻醉,隨機分為兩組,每組60例。對照組給予丙泊酚1 mg·kg~(-1)靜脈輸注5 min后以2 mg·kg~(-1)·h~(-1)持續(xù)泵注;試驗組給予右美托咪定1μg·kg~(-1)靜脈輸注10 min后以0.5μg·kg~(-1)·h~(-1)持續(xù)泵注。記錄入室時(T_0),椎管內(nèi)麻醉后10 min(T_1),給藥后5 min(T_2)、10 min(T_3)、20 min(T_4)、40 min(T_5)、60 min(T_6),術(shù)畢(T_7)和術(shù)后1 h(T_8)的心率(HR)、平均動脈壓(MAP)、BIS值、RSS和不良反應(yīng)發(fā)生情況,采用Spearman秩相關(guān)性檢驗分析RSS與BIS的相關(guān)性。結(jié)果兩組T_3~T_5時的HR均較T_0時降低(P0.05),且試驗組HR低于對照組(P0.05)。兩組T__2~T__5時的MAP均較T_0時降低(P0.05),且對照組MAP低于試驗組(P0.05)。兩組鎮(zhèn)靜深度均滿足手術(shù)要求,對照組和試驗組的BIS值與RSS均呈負相關(guān)性(P0.05),r值分別為-0.85和-0.88。試驗組呼吸抑制、低血壓和躁動發(fā)生率低于對照組(P0.05)。結(jié)論較丙泊酚,右美托咪定輔助老年患者鎮(zhèn)靜時不良反應(yīng)發(fā)生少,BIS與RSS相關(guān)性良好并能夠達到使用丙泊酚時的水平,BIS是評價鎮(zhèn)靜深度的良好客觀指標。
[Abstract]:Objective to observe the correlation between bispectral index (BIS) and Ramsay sedative score (Ramsay sedative score) in elderly patients with spinal epidural anesthesia assisted sedation. Methods 120 patients undergoing knee arthroplasty were treated with spinal epidural anesthesia. The control group was given propofol (1 mg 路kg ~ (-1)) intravenously for 5 min and then 2 mg 路kg ~ (-1) 路h ~ (-1) 路h ~ (-1). The trial group was given dexmetomidine 1 渭 g / kg / kg for 10 min after intravenous infusion for 10 min with 0.5 渭 g / kg / h / h / h))) continuous pump injection. The heart rate, mean arterial pressure, mean arterial pressure, BIS value and RSS were observed at room entry, 10 mins after intraspinal anesthesia, 10 min after intraspinal anesthesia, 20 min, 20 min, 5 min, 5 min, 5 min, 5 min, 5 min, 20 min, 5 min, 5 min, 40 min, T 560 min, T 6, T7 and 1 h T 8 after operation), mean arterial pressure, mitogen-BIS value and no RSS at the end of the operation and 1 h after operation. The occurrence of good reactions, Spearman rank correlation test was used to analyze the correlation between RSS and BIS. Results the HR of T_3~T_5 in both groups was lower than that of the control group at 0, and the HR of the test group was lower than that of the control group. The MAP at T__2~T__5 in both groups was lower than that in T0, and the MAP in the control group was lower than that in the test group. The depth of sedation in group A met the requirement of operation. There was a negative correlation between BIS and RSS in the control group and the trial group, respectively, and the r values were -0.85 and -0.88 respectively. The incidence of hypotension and restlessness in the experimental group was lower than that in the control group (P 0.05). There was a good correlation between dexmetomidine and RSS during sedation in elderly patients, and it was a good objective index to evaluate sedation depth when propofol was used.
【作者單位】： 河北醫(yī)科大學(xué)第三醫(yī)院麻醉科;哈勵遜國際和平醫(yī)院麻醉科;河北醫(yī)科大學(xué)法醫(yī)系;
【基金】：河北省醫(yī)學(xué)科學(xué)研究重點課題計劃(ZL20140225)
【分類號】：R614

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