右美托咪定联合胸椎旁神经阻滞在乳腺手术中的临床应用(第四次).docVIP

右美托咪定联合胸椎旁神经阻滞在乳腺手术中的临床应用 田文华，高嵩，杨帆，魏常 ，汤世玉 ，王磊 ，罗锋（武汉市汉口医院麻醉科， 武汉，430012） 摘要 ：　探讨右美托咪定联合胸椎旁神经阻滞应用于乳腺手术的有效性及安全性。　择乳腺手术用随机余数法为三组，每组30即组（右美托咪定组）、组（咪达唑仑组）和组（对照组），组与组分别于胸椎旁神经阻滞前开始静脉注入等剂量的右美托咪定（负荷量.5μg／ｇ、ｍｉｎ内注完）及生理盐水， 组于胸椎旁神经阻滞前静脉注入咪达唑仑ｍｇ／ｋｇ，观察手术中芬太尼的用量并记录入室（０）、胸椎旁神经阻滞穿刺前（１）、切皮（２）、３）、手术结束（４）时的、、警觉／镇静评分（）。　与组比较，组１～４ 时明显降低、明显减慢；２、３ 时明显增快（＜）；组２ 时明显高于组和组（＜）。～时的组和１、２ 时的组OAA／S评分明显低于组（＜）。组和组需要使用芬太尼的量明显低于组（＜）。　右美托咪定可安全有效地应用于胸椎旁神经阻滞下乳腺手术手术的辅助镇静。 ：右美托咪定；胸椎旁神经 ；乳腺手术；Dexmedetomidine combined thoracic nerve block next scheduled clinical application in breast surgery TIAN Wenhua, Gao Song, Yang Fan, Wei Chang, Tang Shiyu, Wang Lei, Luo Feng (Department of Anesthesiology, Wuhan City, Hankou Hospital of Wuhan, 430012) Abstract: Objective To investigate the dexmedetomidine next scheduled joint thoracic nerve block used in breast surgery efficacy and safety. Methods of breast surgery were 90 rows, with the remainder divided into three random groups of 30, namely D group (dexmedetomidine given group), M group (midazolam group) and Group C (control group) , D and C group were beside thoracic nerve block 15min before the start of intravenous injection of the same dose given dexmedetomidine (loading dose of 0.5μg / kg, injection completed within 10min) and saline, M group beside the thoracic nerve blocking 15min delay before intravenous injection of midazolam 0.1mg / kg, the amount of fentanyl observed surgery and recorded burglary (T0), before the next puncture thoracic nerve block (T1), skin incision (T2), tumor resection (T3 ), HR (heart rate) the end of surgery (T4) when, RR (breathing), MAP (mean arterial pressure), SPO2 (oxygen saturation) and alertness / sedation score (OAA / S). Results Compared with group C, D group T1 ~ T4 significantly reduced when the MAP, HR slowed down; T2, T3 when RR was significantly faster (P 0.05); D group was significantly higher than T2, SPO2 group M and group C (P 0.05). T1 ~ T4 when the M group and T1, D group when OAA T2 / S scores were signific