小剂量右美托咪定在高原地区老年肺心病患者椎管内麻醉中的应用

发布时间：2018-04-23 23:27

  本文选题：右美托咪定 + 高原地区　； 参考：《高原医学杂志》2016年02期

【摘要】：目的:观察小剂量右美托咪定对高原地区老年肺心病患者椎管内麻醉术中镇静的临床应用。方法:择期行下肢骨科手术老年肺心病患者30例,行连硬外麻醉,将患者按随机数字分为右美托咪定组(DEX组)和生理盐水组(对照组)各15例,记录患者麻醉后,给予DEX即时、给药10min、20min、30min、60min及术毕时的血压、心率、呼吸频率、SpO_2、PETCO_2,BIS值及镇静/警觉(OAA/S)评分。结果:两组患者的心率、呼吸频率、SpO_2及PETCO_2在组间和组内比较均无明显改变;DEX组患者的SBP、DBP及MAP与给药即时比较明显降低(P0.05),降低幅度为给药即时的10%~15%,对照组患者血压无明显改变;DEX组给药后各时间点产生明显镇静效应,明显低于对照组,差异有统计学意义(P0.05)。结论:小剂量右美托咪定静脉连续输注可对老年患者产生明显镇静、抗交感及抗焦虑作用,无明显的循环呼吸抑制,镇静后的患者易合作,特别适合术前合并缺氧心肺功能改变的高原地区的高龄患者。
[Abstract]:Objective: to observe the clinical application of low dose dexmetomidine in spinal canal anesthesia in elderly patients with cor pulmonale at high altitude. Methods: thirty elderly patients with cor pulmonale undergoing orthopaedic surgery of lower extremities were randomly divided into two groups: dexmetomidine group (n = 15) and saline group (n = 15). After anesthesia, patients were given DEX immediately. Blood pressure, heart rate, respiratory frequency, SpO2PETCO2BIS and OAA / S score at the end of operation. Results: heart rate of the two groups, Respiratory frequency SpO2 and PETCO_2 were not significantly changed in both groups and within groups. SBPnDBP and MAP in DEX group were significantly lower than those in the immediate treatment group, and decreased by 10% and 1515% respectively. There was no significant change in blood pressure in the control group after the drug was given to the patients in the DEX group each time after administration of the drug, there was no significant change in the blood pressure of the patients in the control group. The time point has a significant sedative effect, The difference was significantly lower than that of the control group (P 0.05). Conclusion: continuous intravenous infusion of low-dose dexmetomidine can induce sedation, anti-sympathetic and anti-anxiety effects in elderly patients. There is no obvious circulatory respiratory inhibition, and the patients after sedation are easy to cooperate. It is especially suitable for the elderly patients with hypoxic cardiopulmonary function changes at high altitude before operation.
【作者单位】： 青海省交通医院麻醉科;
【分类号】：R614
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本文编号：1794129