Dexmedetomidine Elderly critically ill patient Postoperative

  本文关键词：右美托咪定对老年重症患者术后谵妄的影响，由笔耕文化传播整理发布。

右美托咪定对老年重症患者术后谵妄的影响

The effect of dexmedetomidine on the incidence of postoperative delirium in critically ill elderly patients

[1] [2] [3]

YAO Yue-Qin, WANG Dong-Xin, SHI Cheng-Mei. Department of Anesthesiology, First Hospital, Peking University, Beijing 100034, China

北京大学第一医院麻醉科,100034

文章摘要：目的观察右美托咪定老年重症患者术后谵妄发生的影响。方法60例行择期硬膜外复合全麻下腹部手术术后入SICU患者，年龄≥65岁。随机均分为治疗组和对照组，治疗组持续静脉输注右美托咪定0．2μg·kg^-1·h^-1直至总剂量达200μg（用生理盐水稀释至50ml），，；对照组给予等容量生理盐水。观察术后第1、2、3天静息和咳嗽时VAS疼痛评分和睡眠评分，术后6、12h、停药时、术后24、48h镇痛泵的按压次数和用药量情况及术后7d内谵妄发生率。结果两组低血压发生率、VAS疼痛评分差异无统计学意义。术后第1天睡眠评分治疗组（3．48±2．19）分，明显低于对照组的（4．67±2．44）分（P〈0．05）。术后7d内对照组谵妄发生率9例（31．0％），治疗组13例（44．8％），两组差异无统计学意义。结论老年外科重症患者，持续静脉输注右美托咪定0．2μg·k-1·h^-1能改善睡眠质量，对术后镇痛及谵妄发生无明显影响。

Abstr：Objective To evaluate the effect of dexmedetomidine on the incidence of postoperative delirium in critically ill elderly patients. Methods Sixty patients who were 65 years or older, having underwent intra-abdominal surgery under combined epidural-general anesthesia were randomly divided into two groups. In treatment group, dexmedetomidine was administrated as an intravenous infusion at the rate of 0.2μg· kg-1 ·h-1 until the total dose of 200 μg. In the control group, normal saline was given. The visual analogue scores （VAS） of pain at rest and on coughing, VAS score of sleep, as well as the times of demands and the total consumption of PCEA were recorded. The occurrence of postoperative delirium was evaluated regularly until the seventh postoperative day. Results The incidence of hypotension was slightly higher in treatment group than in control group （P《0.05）. There were no significant differences between two groups in the VAS pain scores, the total demand times, effective demand times and the total drug consumption of PCEA. The VAS score of sleep was significantly lower in treatment group than in control group on the first postoperative day [（3.48 ± 2.19） vs. （4.67 ± 2.44）, P〈 0.05]. There were no significant differences between two groups in postoperative dolirium of nine cases （31.0%） in control group and in 13 cases （44. 8%） in treatment group. Conclusion In the critically ill elderly patients, continuous intravenous infusion of dexmedetomidine at the rate of 0. 2 μg· kg-1 ·h-1 may improve sleep quality, had no significant influence on the analgesic effects of PCEA and on the incidence of postoperative deliriurn.

文章关键词：

Keyword：:Dexmedetomidine Elderly critically ill patient Postoperative delirium

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  本文关键词：右美托咪定对老年重症患者术后谵妄的影响，由笔耕文化传播整理发布。