右旋美托咪啶对老年腰椎手术中血流动力学及认知能力的影响

发布时间：2018-03-14 21:12

  本文选题：腰椎　切入点：麻醉　出处：《中国组织工程研究》2015年11期 　论文类型：期刊论文

【摘要】：背景:目前临床常用的麻醉药对老年患者围手术期的血流动力学和认知功能均产生一定的影响,有研究报道右旋美托咪啶对肾上腺素能受体具有高亲和力,可能对血流动力学影响甚小。目的:观察采用右美托咪定对老年腰椎手术麻醉血流动力学及认知功能的影响。方法:选择腰椎手术的60岁以上美国麻醉医师协会(ASA)Ⅰ-Ⅱ级拟行择期腰椎手术患者90例,随机分为3组,每组患者30例。0.5μg组、1.0μg组患者均于麻醉诱导后按照右美托咪定1.0μg/kg给予负荷剂量,输注15 min,然后分别按照0.5μg、1.0μg持续泵入,对照组给予等量生理盐水。3组患者的麻醉诱导均采用咪唑安定0.04 mg/kg+芬太尼5μg/kg+维酷溴铵0.1 mg/kg。比较3组患者的镇静评估及遗忘程度、全麻插管期血流动力学稳定性、术后认知功能的差异。结果与结论:用药后5,10 min的听觉诱发电位指数3组间差异有显著性意义(P0.05),1.0μg组显著低于0.5μg组和对照组(P0.05),0.5μg组显著低于对照组(P0.05)。用药10 min后1.0μg组患者改良警觉/镇静视觉评分显著低于0.5μg组和对照组(P0.05)。1.0μg组、0.5μg组5,10,20,30,60 min时刻的收缩压均显著高于对照组,给药后各时间点舒张压均显著高于对照组(P0.05)。1.0μg组的术后认知功能障碍发生率显著低于0.5μg组和对照组(P0.05)。结果提示全麻镇痛中采用右美托咪定有利于患者术中血流动力学稳定,降低术后认知障碍的发生。
[Abstract]:Background: at present, the perioperative period in elderly patients with hemodynamic and cognitive function in clinical commonly used anesthetics may have certain effect, there are reports of dexmedetomidine on adrenergic receptors with high affinity, may affect the hemodynamics is very small. Objective: To observe the effect of using dexmedetomidine anesthesia blood flow dynamics and cognitive function the elderly lumbar surgery. Methods: lumbar surgery over the age of 60 American Society of anesthesiologists (ASA) grade to 90 patients who underwent elective lumbar surgery, were randomly divided into 3 groups, each group of 30 cases of patients with.0.5 G group, 1 g group of patients after induction of anesthesia with dexmedetomidine 1 g/kg loading dose, infusion of 15 min, and then according to the 0.5 g, 1 g continuous infusion, the control group was given normal saline.3 group anesthesia induced with midazolam 0.04 mg/kg+ fentanyl 5 g/kg+ dimension 閰锋捍閾，

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