右美托咪定对老年白内障手术球后神经阻滞患者镇静效果的最佳维持剂量

发布时间：2018-03-30 15:01

本文选题：白内障　切入点：球后神经阻滞　出处：《中国老年学杂志》2017年09期

【摘要】：目的探讨右美托咪定对老年白内障手术球后神经阻滞患者镇静效果的最佳维持剂量。方法白内障手术的90例老年患者随机分为3组各30例。由同一位医生行球后神经阻滞麻醉,麻醉完毕10 min内,3组分别以0.2、0.4、0.6μg·kg~(-1)·h~(-1)的速率静脉维持给予右美托咪定。记录并比较3组入室时(T0)、神经阻滞完毕即刻(T1)、用药后10 min(T2)、20 min(T3)、30 min(T4)、60 min(T5)时的心率(HR)、呼吸频率(BR)、平均动脉压(MAP)、Ramsay镇静评分(RSS)及口述评分法(VRS)。评价并比较3组手术前后焦虑自评量表(SAS)评分及术后患者、医生满意度评分。结果 3组在T2~T5时间点时的RSS均明显大于T0时,HR水平均明显小于T0时,并且观察3组在T3~T5时间点时的RSS均明显大于观察1组和观察2组、HR水平均明显小于观察1组和观察2组(P0.05);3组在各时间点时的VRS、BR、MAP比较差异均无统计学意义(P0.05)。观察1组和观察2组的患者满意度均明显高于观察3组(P0.05);3组术前SAS评分、术后SAS评分及医生满意度评分比较差异均无统计学意义(P0.05)。结论右美托咪定对老年白内障手术球后神经阻滞患者镇静效果的最佳维持剂量为0.2~0.4μg·kg~(-1)·h~(-1)。
[Abstract]:Objective to investigate the optimal maintenance dose of dexmetomidine for the sedation effect of retrobulbar nerve block in senile cataract surgery. Methods 90 elderly patients undergoing cataract surgery were randomly divided into 3 groups, 30 cases in each group, and 30 cases were treated with retrobulbar nerve block anesthesia by the same doctor. Within 10 min after anesthesia, dexmetomidine was administered intravenously at a rate of 0.2 卤0.4 渭 g / kg, respectively. The heart rate, respiratory frequency (BRBRR), mean arterial artery (mean arterial) were recorded and compared between the three groups at 10 min after anesthesia. The heart rate and respiratory frequency of the three groups were recorded and compared at 10 minutes after 10 minutes of anesthesia. The heart rate, respiratory frequency, and mean artery were measured at 10 minutes and 20 minutes after the anesthesia, and 10 minutes after the treatment, the heart rate and respiratory frequency of the three groups were measured. Ramsay sedative score (RSSs) and oral score (VRS) were used to evaluate and compare the scores of SASs before and after operation in three groups. Results the RSS of the three groups at T2~T5 time was significantly higher than that at T0 and HR level was significantly lower than that at T0. In addition, the RSS HR levels of the three groups at T3~T5 time point were significantly higher than those in the observation group 1 and the observation group 2, respectively. There was no significant difference between the three groups at each time point (P 0.05), and there was no significant difference between the observation group 1 and the observation group 1 at each time point. The patients' satisfaction degree in the two groups was significantly higher than that in the three groups (P < 0.05) and the preoperative SAS score was higher than that in the control group (P < 0.05). There was no significant difference in postoperative SAS score and doctor satisfaction score (P 0.05). Conclusion the best maintenance dose of dexmetomidine for senile patients with posterior ball nerve block after cataract surgery is 0. 2 卤0. 4 渭 g 路kg ~ (-1) 路kg ~ (-1) 路h ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1).
【作者单位】：中山大学中山眼科中心海南眼科医院麻醉科;
【分类号】：R614

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