右美托咪定辅助老年患者镇静时脑电双频指数与Ramsay镇静评分的相关性

发布时间：2018-03-26 10:20

本文选题：老年人　切入点：右美托咪定　出处：《中国新药与临床杂志》2017年05期

【摘要】：目的观察右美托咪定用于老年患者脊椎-硬膜外麻醉辅助镇静时脑电双频指数(BIS)与Ramsay镇静评分(RSS)的相关性。方法选取拟行膝关节置换术患者120例,均行脊椎-硬膜外麻醉,随机分为两组,每组60例。对照组给予丙泊酚1 mg·kg~(-1)静脉输注5 min后以2 mg·kg~(-1)·h~(-1)持续泵注;试验组给予右美托咪定1μg·kg~(-1)静脉输注10 min后以0.5μg·kg~(-1)·h~(-1)持续泵注。记录入室时(T_0),椎管内麻醉后10 min(T_1),给药后5 min(T_2)、10 min(T_3)、20 min(T_4)、40 min(T_5)、60 min(T_6),术毕(T_7)和术后1 h(T_8)的心率(HR)、平均动脉压(MAP)、BIS值、RSS和不良反应发生情况,采用Spearman秩相关性检验分析RSS与BIS的相关性。结果两组T_3~T_5时的HR均较T_0时降低(P0.05),且试验组HR低于对照组(P0.05)。两组T__2~T__5时的MAP均较T_0时降低(P0.05),且对照组MAP低于试验组(P0.05)。两组镇静深度均满足手术要求,对照组和试验组的BIS值与RSS均呈负相关性(P0.05),r值分别为-0.85和-0.88。试验组呼吸抑制、低血压和躁动发生率低于对照组(P0.05)。结论较丙泊酚,右美托咪定辅助老年患者镇静时不良反应发生少,BIS与RSS相关性良好并能够达到使用丙泊酚时的水平,BIS是评价镇静深度的良好客观指标。
[Abstract]:Objective to observe the correlation between bispectral index (BIS) and Ramsay sedative score (Ramsay sedative score) in elderly patients with spinal epidural anesthesia assisted sedation. Methods 120 patients undergoing knee arthroplasty were treated with spinal epidural anesthesia. The control group was given propofol (1 mg 路kg ~ (-1)) intravenously for 5 min and then 2 mg 路kg ~ (-1) 路h ~ (-1) 路h ~ (-1). The trial group was given dexmetomidine 1 渭 g / kg / kg for 10 min after intravenous infusion for 10 min with 0.5 渭 g / kg / h / h / h))) continuous pump injection. The heart rate, mean arterial pressure, mean arterial pressure, BIS value and RSS were observed at room entry, 10 mins after intraspinal anesthesia, 10 min after intraspinal anesthesia, 20 min, 20 min, 5 min, 5 min, 5 min, 5 min, 5 min, 20 min, 5 min, 5 min, 40 min, T 560 min, T 6, T7 and 1 h T 8 after operation), mean arterial pressure, mitogen-BIS value and no RSS at the end of the operation and 1 h after operation. The occurrence of good reactions, Spearman rank correlation test was used to analyze the correlation between RSS and BIS. Results the HR of T_3~T_5 in both groups was lower than that of the control group at 0, and the HR of the test group was lower than that of the control group. The MAP at T__2~T__5 in both groups was lower than that in T0, and the MAP in the control group was lower than that in the test group. The depth of sedation in group A met the requirement of operation. There was a negative correlation between BIS and RSS in the control group and the trial group, respectively, and the r values were -0.85 and -0.88 respectively. The incidence of hypotension and restlessness in the experimental group was lower than that in the control group (P 0.05). There was a good correlation between dexmetomidine and RSS during sedation in elderly patients, and it was a good objective index to evaluate sedation depth when propofol was used.
【作者单位】：河北医科大学第三医院麻醉科;哈励逊国际和平医院麻醉科;河北医科大学法医系;
【基金】：河北省医学科学研究重点课题计划(ZL20140225)
【分类号】：R614

【相似文献】