右美托咪定在高龄患者硬膜外麻醉中镇静效果的观察

发布时间：2018-05-12 08:24

本文选题：右美托咪定 + 高龄　；参考：《重庆医学》2017年20期

【摘要】：目的观察右美托咪啶(Dex)对硬膜外麻醉患者的镇静效应及其对呼吸循环的影响。方法选择180例下肢手术患者,行硬膜外麻醉,麻醉效果测试满意后,用微量泵泵注Dex。分为D1、D2、D3组,每组60例。D1组Dex负荷量0.2μg/kg,10min内泵完,然后以0.1μg·kg~(-1)·h~(-1)维持输注;D2组Dex负荷量0.5μg/kg,10min内泵完,然后以0.2μg·kg~(-1)·h~(-1)维持输注;D3组为对照,泵注等量生理盐水。记录给药前(T0)、输注负荷量结束即刻(T1)、输注维持量5min(T2),输注维持量10min(T3)、输注维持量30min(T4)、停止输注后10min(T5)、停止输注后30min(T6)时的脑电双频谱指数(BIS)、平均动脉压(MAP)、心率(HR)、呼吸(RR)、血氧饱和度(SpO_2),并对患者进行Ramsay镇静评分。结果 T1~T6时点D1组患者的MAP、SpO_2、RR与其他组相比差异无统计学意义(P0.05)。D1组患者的HR与D2组相比较差异有统计学意义(P0.05)。D1、D2组BIS、Ramsay值与D3组相比差异有统计学意义(P0.05)。D2组心动过缓发生率95%,有23例经阿托品对症处理或暂停输注DEX,而D1组心动过缓有15%,且程度较轻,经暂停输注DEX好转,仅有2例给予阿托品处理。结论小剂量Dex用于高龄(70岁以上)患者硬膜外麻醉期间有良好镇静效果,且心率更稳定,安全性更高。
[Abstract]:Objective to observe the sedation effect of dexmetidine on epidural anesthesia and its effect on respiration and circulation. Methods 180 patients undergoing lower extremity operation were treated with epidural anesthesia. Each group was divided into two groups: group D _ (1) D _ (2) D _ (2) D _ (3), each group (n = 60) with Dex loading 0.2 渭 g / kg ~ (-1) within 10 minutes, and then with 0.1 渭 g 路kg ~ (-1) 路h ~ (-1) 路h ~ (-1) Dex in D _ 2 group within 10 minutes, then 0.2 渭 g 路kg ~ (-1) h ~ (-1) Dex was administered to D3 group as control group, and the same amount of normal saline was injected into D _ (3) group. The bispectral index of BISI, mean arterial pressure MAPP, heart rate, respiratory RRR, blood oxygen were recorded before administration of T0, T0, T1, T1, T2, T3, T3, T5, T5 and T6, respectively, at 10 min after infusion and 30 min after T6), mean arterial pressure MAPP, heart rate, respiratory RRR, and blood oxygenation at the end of the infusion period (T0, T0, T1, T1, T2, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T5, T6). The patients were treated with Ramsay sedation score. Results there was no significant difference between T1~T6 and other groups. HR of group D1 was significantly different from that of group D2. There was a significant difference in bradycardia between group D _ 2 and group D _ 3 compared with group D _ 3. There was a significant difference in bradycardia between group D _ 2 and group D _ 3. The birth rate was 95%, 23 cases were treated with atropine or stopped infusion of DEX, while 15 cases of bradycardia in group D1 were mild, After suspension of DEX, only 2 cases were treated with atropine. Conclusion low dose Dex has good sedation effect during epidural anesthesia in elderly patients over 70 years old, and the heart rate is more stable and safe.
【作者单位】：重庆市荣昌区人民医院麻醉科;
【分类号】：R614

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