右美托咪定复合舒芬太尼在肝癌微波消融术中的应用

发布时间：2019-01-03 11:02

【摘要】：目的探讨右美托咪定复合舒芬太尼在肝癌微波消融术中的应用价值。方法选择60例拟行CT引导下肝癌微波消融的患者,分为Y组30例和C组30例。入室常规监测血压、心率(HR)、脉搏氧饱和度(Sp O2)。实验药物专人配制,右美托咪定按1μg/m L配制,共20 m L,生理盐水20 m L。Y组2 min缓慢静脉注射右美托咪定0.2μg/kg,同法,C组缓慢给予生理盐水0.2 m L/kg静脉注射作为安慰剂。舒芬太尼则按0.1μg/kg作为首量静脉注射。术中按视觉模拟评分法(VAS)评估患者的疼痛程度,评分3则给予舒芬太尼0.1μg/kg静脉注射,必要时可重复给药。记录入室后5 min(T1)、麻醉开始5 min(T2)、微波消融5 min(T3)、手术结束时(T4)4个时点的血压、HR、Sp O2、舒芬太尼的用量、Wilson镇静分级、麻醉时间、微波消融的时间、围术期出现的不良反应。结果 Y组患者在麻醉诱导后的HR和血压均低于C组,差异有统计学意义(P0.05);Y组患者的镇静评分高于C组(P0.05);Y组患者的舒芬太尼用量少于C组(P0.05);Y组患者恶心、呕吐、胸壁僵直等不良反应的发生率小于C组(P0.05);而Y组患者呼吸抑制、心动过缓、高血压、低血压等不良反应的发生率与C组相仿(P0.05)。结论右美托咪定0.2μg/kg复合舒芬太尼有助于增强肝微波消融患者的镇静、镇痛程度,减少舒芬太尼的用量,减少恶心、呕吐、胸壁僵直等不良反应,同时并不会增加呼吸抑制、心动过缓、高血压、低血压等不良反应。
[Abstract]:Objective to investigate the value of dexmetomidine combined with sufentanil in microwave ablation of liver cancer. Methods 60 patients with hepatocellular carcinoma undergoing CT guided microwave ablation were divided into Y group (30 cases) and C group (30 cases). Blood pressure and heart rate (HR), pulse oxygen saturation (Sp O 2) were monitored. The experimental drug was prepared with dexmetomidine at 1 渭 g / mL for a total of 20 mL. Dexmetomidine 0.2 渭 g / kg was injected intravenously for 2 min in the saline 20ml Y group, the same method was used. Group C was given saline 0.2 m L/kg intravenously as a placebo. Sufentanil was first intravenously injected at 0. 1 渭 g/kg. The pain degree was evaluated by visual analogue score (VAS) during operation, and sufentanil 0.1 渭 g/kg was given intravenously in score 3, and repeated administration if necessary. The blood pressure of 5 min (T1), 5 min (T2) of anesthesia, 5 min (T3) of microwave ablation, 4 points of blood pressure at the end of operation (T4), the dosage of HR,Sp O2, sufentanil, Wilson sedation grade and anesthesia time were recorded. Time of microwave ablation, perioperative adverse reactions. Results the HR and blood pressure of group Y were lower than those of group C after anesthesia induction, and the difference was statistically significant (P0.05). The sedation score of group); Y was higher than that of group C (P0.05). The dosage of sufentanil in group); Y was lower than that in group C (P0.05). The incidence of adverse reactions such as nausea vomiting chest wall stiffness in group Y was lower than that in group C (P0.05) while the incidence of adverse reactions such as respiratory depression bradycardia hypertension hypotension in group Y was similar to that in group C (P0.05). Conclusion dexmetomidine 0.2 渭 g/kg combined with sufentanil can enhance the sedation, analgesia, decrease the dosage of sufentanil, reduce nausea, vomiting, rigidity of chest wall, and so on. At the same time does not increase respiratory inhibition, bradycardia, hypertension, hypotension and other adverse reactions.
【作者单位】：中山大学附属第一医院麻醉科;中山大学附属第一医院检验科;中山大学附属第一医院介入科;
【分类号】：R614;R735.7

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