不同剂量右美托咪定在老年椎管内麻醉下宫腔镜手术患者的应用效果

发布时间：2018-04-22 13:02

本文选题：右美托咪定 + 宫腔镜　；参考：《中国老年学杂志》2017年10期

【摘要】：目的探讨不同剂量右美托咪定(DEX)在老年椎管内麻醉下宫腔镜手术患者中的应用效果。方法宫腔镜手术发生寒战的老年患者80例,按随机数字表法分为对照组、曲马多组、DEX低剂量组和DEX高剂量组,每组20例,在围术期发生寒战反应后分别给予生理盐水、曲马多1.0 mg/kg、DEX 0.5μg/kg和DEX 1.0μg/kg,记录患者在给药前(T0)、给药5 min(T1)、15 min(T2)、30 min(T3)和手术结束时(T4)的寒战评分、镇静评分和不良反应发生情况。结果对照组各时刻寒战评分与T0时刻基本相当且高于同时刻的其他组(P0.05);曲马多组、DEX低剂量组及DEX高剂量组T1时刻寒战评分开始下降,DEX高剂量组下降最快(P0.05);镇静评分T0、T1、T3和T4时各组间差异均无统计学意义(P0.05),T2时DEX高剂量组高于其余3组(P0.05);DEX低剂量组及DEX高剂量组不良反应发生率均显著低于对照组和曲马多组,DEX高剂量组亦低于DEX低剂量组(P0.05)。结论右美托咪定应用于老年椎管内麻醉后宫腔镜手术患者具有确切的抗寒战效果,同时能有效减少恶心呕吐不良反应的发生率,且高剂量运用效果更明显。
[Abstract]:Objective to evaluate the efficacy of dexmetidine in hysteroscopic surgery under intraspinal anesthesia in elderly patients. Methods Eighty elderly patients undergoing hysteroscopic chills were randomly divided into control group, tramadol low dose group and DEX high dose group. 20 cases in each group were given normal saline after shivering reaction during perioperative period. Tramadol 1.0 mg / kg DEX 0.5 渭 g/kg and DEX 1.0 渭 g / kg were used to record the shivering score, sedation score and adverse reaction rate of T0, T0, T1, T2, T3 and T4 at the end of operation. Results the scores of shivering at each time in the control group were similar to those at T0 and were higher than those in other groups at the same time (P0.05A), the scores of shivering at T1 time in the tramadol group and the high dose group of DEX began to decrease at T1 time, and the sedative score of the high dose group decreased the most rapidly (P0.05A). There was no significant difference between the three groups at T0, T1, T 3 and T 4. The incidence of adverse reactions in the high dose DEX group was significantly higher than that in the other three groups. The incidence of adverse reactions in the low dose group and the high dose group of DEX were significantly lower than those in the control group and tramadol group. The incidence of adverse reactions in the high dose group was lower than that in the low dose group of DEX group, and that in the tramadol group was also lower than that in the low dose group of DEX group. Conclusion dexmetomidine is effective in the treatment of hysteroscopic surgery after spinal canal anesthesia in elderly patients. It can effectively reduce the incidence of adverse reactions of nausea and vomiting, and the effect of high dose application is more obvious.
【作者单位】：深圳市宝安区人民医院(集团)第一人民医院麻醉科;
【基金】：深圳市宝安区科技计划社会公益项目(2015037)
【分类号】：R614

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