右美托咪定对老年人硬膜外麻醉下开腹胆囊切除术牵拉反应的影响

发布时间：2018-05-15 05:02

本文选题：右美托咪定 + 硬膜外麻醉　；参考：《中国老年学杂志》2016年24期

【摘要】：目的观察右美托咪定用于老年人开腹胆囊切除手术对内脏牵拉反应的影响。方法择期硬膜麻醉下行小切口开腹胆囊切除手术患者60例。随机分成右美托咪定组及氟芬组。右美托咪定组患者手术切皮时开始静脉输注右美托咪定0.5μg/kg,20 min输注完毕;氟芬组患者手术切皮时静注氟芬合剂2 ml。监测并记录注药前(T0)、注药后5 min(T1)、注药后10 min(T2)、牵拉胆囊时(T3)、手术结束时(T4)五个时点的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉搏血氧饱和度(SpO_2)、镇静效果,并记录术中牵拉胆囊时有无上腹部不适、恶心呕吐、鼓肠、牵拉痛等牵拉反应发生。结果右美托咪定组抑制胆囊牵拉反应有效率为90%,氟芬组抑制胆囊牵拉反应有效率为57%,两组差异显著(P0.05)。结论右美托咪定用于老年人小切口开腹胆囊切除手术,能有效抑制胆囊牵拉反应不良反应少。
[Abstract]:Objective to observe the effect of dexmetomidine on visceral traction in elderly patients undergoing open cholecystectomy. Methods 60 patients with small incision cholecystectomy under selective epidural anesthesia. The patients were randomly divided into two groups: dexmetomidine group and flufen group. The patients in the dexmetomidine group received intravenous infusion of dexmetomidine 0.5 渭 g / kg for 20 min at the time of skin incision, while the patients in the fluorophen group were given 2 ml of fluphene mixture at the time of skin incision. The mean arterial pressure (MAPP) was monitored and recorded at 5 min after injection, 5 min after injection, 10 min after injection, and 10 min after injection. The mean arterial pressure (MAPP) was recorded at five time points: heart rate (HRV), respiratory frequency (RGR), pulse oxygen saturation (SPO 2), sedative effect. The abdominal discomfort, nausea and vomiting, tympanic bowel, traction pain and so on were recorded. Results the effective rate of dexmetomidine group in inhibiting gallbladder traction reaction was 90%, and that of floufen group was 57%. The difference between the two groups was significant (P 0.05). Conclusion dexmetomidine can effectively inhibit the adverse reaction of gallbladder traction in the elderly with small incision open cholecystectomy.
【作者单位】：内蒙古医科大学附属医院麻醉科;
【基金】：内蒙古自治区卫生厅项目(No.201302060)
【分类号】：R614

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