本文選題：白內(nèi)障　切入點(diǎn)：球后神經(jīng)阻滯　出處：《中國(guó)老年學(xué)雜志》2017年09期

【摘要】：目的探討右美托咪定對(duì)老年白內(nèi)障手術(shù)球后神經(jīng)阻滯患者鎮(zhèn)靜效果的最佳維持劑量。方法白內(nèi)障手術(shù)的90例老年患者隨機(jī)分為3組各30例。由同一位醫(yī)生行球后神經(jīng)阻滯麻醉,麻醉完畢10 min內(nèi),3組分別以0.2、0.4、0.6μg·kg~(-1)·h~(-1)的速率靜脈維持給予右美托咪定。記錄并比較3組入室時(shí)(T0)、神經(jīng)阻滯完畢即刻(T1)、用藥后10 min(T2)、20 min(T3)、30 min(T4)、60 min(T5)時(shí)的心率(HR)、呼吸頻率(BR)、平均動(dòng)脈壓(MAP)、Ramsay鎮(zhèn)靜評(píng)分(RSS)及口述評(píng)分法(VRS)。評(píng)價(jià)并比較3組手術(shù)前后焦慮自評(píng)量表(SAS)評(píng)分及術(shù)后患者、醫(yī)生滿意度評(píng)分。結(jié)果 3組在T2~T5時(shí)間點(diǎn)時(shí)的RSS均明顯大于T0時(shí),HR水平均明顯小于T0時(shí),并且觀察3組在T3~T5時(shí)間點(diǎn)時(shí)的RSS均明顯大于觀察1組和觀察2組、HR水平均明顯小于觀察1組和觀察2組(P0.05);3組在各時(shí)間點(diǎn)時(shí)的VRS、BR、MAP比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。觀察1組和觀察2組的患者滿意度均明顯高于觀察3組(P0.05);3組術(shù)前SAS評(píng)分、術(shù)后SAS評(píng)分及醫(yī)生滿意度評(píng)分比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論右美托咪定對(duì)老年白內(nèi)障手術(shù)球后神經(jīng)阻滯患者鎮(zhèn)靜效果的最佳維持劑量為0.2~0.4μg·kg~(-1)·h~(-1)。
[Abstract]:Objective to investigate the optimal maintenance dose of dexmetomidine for the sedation effect of retrobulbar nerve block in senile cataract surgery. Methods 90 elderly patients undergoing cataract surgery were randomly divided into 3 groups, 30 cases in each group, and 30 cases were treated with retrobulbar nerve block anesthesia by the same doctor. Within 10 min after anesthesia, dexmetomidine was administered intravenously at a rate of 0.2 鹵0.4 渭 g / kg, respectively. The heart rate, respiratory frequency (BRBRR), mean arterial artery (mean arterial) were recorded and compared between the three groups at 10 min after anesthesia. The heart rate and respiratory frequency of the three groups were recorded and compared at 10 minutes after 10 minutes of anesthesia. The heart rate, respiratory frequency, and mean artery were measured at 10 minutes and 20 minutes after the anesthesia, and 10 minutes after the treatment, the heart rate and respiratory frequency of the three groups were measured. Ramsay sedative score (RSSs) and oral score (VRS) were used to evaluate and compare the scores of SASs before and after operation in three groups. Results the RSS of the three groups at T2~T5 time was significantly higher than that at T0 and HR level was significantly lower than that at T0. In addition, the RSS HR levels of the three groups at T3~T5 time point were significantly higher than those in the observation group 1 and the observation group 2, respectively. There was no significant difference between the three groups at each time point (P 0.05), and there was no significant difference between the observation group 1 and the observation group 1 at each time point. The patients' satisfaction degree in the two groups was significantly higher than that in the three groups (P < 0.05) and the preoperative SAS score was higher than that in the control group (P < 0.05). There was no significant difference in postoperative SAS score and doctor satisfaction score (P 0.05). Conclusion the best maintenance dose of dexmetomidine for senile patients with posterior ball nerve block after cataract surgery is 0. 2 鹵0. 4 渭 g 路kg ~ (-1) 路kg ~ (-1) 路h ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1).
【作者單位】： 中山大學(xué)中山眼科中心海南眼科醫(yī)院麻醉科;
【分類(lèi)號(hào)】：R614

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