右美托咪定联合氢吗啡酮在经T管窦道胆道镜取石术中的应用

发布时间：2018-06-30 03:02

本文选题：右美托咪定 + 氢吗啡酮　；参考：《中国新药与临床杂志》2017年10期

【摘要】：目的探讨右美托咪定联合氢吗啡酮麻醉在经T管窦道胆道镜取石术中的应用效果。方法拟行经T管窦道胆道镜取石患者60例,随机分为观察组和对照组,每组30例。观察组采用右美托咪定(1μg·kg~(-1))联合氢吗啡酮(20μg·kg~(-1))静脉麻醉,对照组采用2%利多卡因5~10 mL联合0.1%肾上腺素0.1 mL窦道内和胆道内局部表面麻醉。两组均在麻醉后5 min开始行经T管窦道胆道镜取石术。观察两组患者给药前(T0)、手术开始(T1)、取石时(T2)、手术结束(T3)、术后1 h(T4)五个时点的生命体征、疼痛VAS评分,记录手术时间及不良反应发生情况。结果 T1、T2、T3时,观察组患者平均动脉压、心率及VAS评分均低于对照组(P0.05);两组各观察时点患者呼吸频率、脉搏血氧饱和度均无显著差异(P0.05)。观察组手术时间(37.5±7.9)min,短于对照组[(44.5±8.6)min,P0.05]。观察组患者满意度优于对照组(P0.05),两组均无严重不良反应发生。结论右美托咪定联合氢吗啡酮麻醉可减轻经T管窦道胆道镜取石患者术中疼痛,缩短手术时间,提高患者满意度。
[Abstract]:Objective to investigate the effect of dexmetomidine combined with hydromorphone anesthesia in T tube choledocholithotomy. Methods 60 patients with choledocholithiasis were randomly divided into observation group and control group with 30 cases in each group. Dexmetomidine (1 渭 g kg ~ (-1) combined with hydromorphone (20 渭 g kg ~ (-1) was used in the observation group, while the control group was anesthetized with 2% lidocaine 510 mL and 0.1% epinephrine 0.1 mL intrasinus and intrabiliary surface anesthesia. Choledocholithiasis via T tube sinus was performed 5 min after anesthesia in both groups. The vital signs, pain VAS, time of operation and adverse reactions were observed at five time points (T0, T1, T2, T3) and 1 hour (T4) after operation in both groups. Results the mean arterial pressure, heart rate and VAS score in the observation group were lower than those in the control group (P0.05), while there was no significant difference in respiratory frequency and pulse oxygen saturation between the two groups (P0.05). The operative time in the observation group was (37.5 卤7.9) min, shorter than that in the control group [(44.5 卤8.6) min (P0.05)]. The patient satisfaction in the observation group was better than that in the control group (P0.05), and no serious adverse reactions occurred in both groups. Conclusion dexmetomidine combined with hydromorphone anesthesia can reduce the pain, shorten the operation time and improve the satisfaction of patients with choledocholithiasis by T tube choledochoscope.
【作者单位】：绍兴市人民医院麻醉科;
【基金】：浙江省临床科研基金项目(2015ZYC-A78) 绍兴市科技计划项目(2015B70056)
【分类号】：R614

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