不同剂量右美托咪啶对高龄关节置换术患者镇静和镇痛影响.docVIP

不同剂量右美托咪啶对高龄关节置换术患者镇静和镇痛的影响 　　[摘要]目的 比?^分析不同剂量右美托咪啶对高龄关节置换术患者镇静和镇痛效果。方法 选取2017年4～10月我院收治的高龄关节置换术84例患者，采取分层随机法分成三组，联合组（28例）采取小剂量右美托咪啶负荷+维持，维持组（28例）采取小剂量右美托咪啶维持，对照组（28例）采取生理盐水静脉滴注，比较三组镇静和镇痛效果。结果 联合组及维持组患者用药后、用药后30 min镇静评分均低于对照组，差异有统计学意义（P0.05）。联合组患者用药后、用药后30 min镇静评分均低于用药后，差异均有统计学意义（P0.05）。维持组患者用药后、用药后30min镇静评分均低于麻醉后，差异有统计学意义（P0.05）。联合组及维持组患者用药后、用药后30 min VAS镇痛评分均低于对照组，差异有统计学意义（P0.05）。联合组及维持组患者用药后、用药后30 min VAS镇痛评分均低于麻醉后，差异均有统计学意义（P0.05）。联合组及维持组患者用药后30 min VAS镇痛评分均低于用药后，差异均有统计学意义（P0.05）。对照组患者用药后30 minVAS镇痛评分低于麻醉后，差异有统计学意义（P0.05）。结论 小剂量右美托咪定持续泵注用于高龄关节置换术中镇静镇痛效果显著，是适宜的手术麻醉方法之一。 　　[关键词]右美托咪啶；高龄；关节置换术；镇静；镇痛 　　[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721（2018）4（c）-0064-03 　　Effects of Dexmedetomidine in different doses on sedation and analgesia in elderly patients with arthroplasty 　　ZHOU Wu-zhao HU Qin-qing LI Hong-qing 　　Department of Anesthesiology，the Second People′s Hospital of Shantou City，Guangdong Province，Shantou 515011，China 　　[Abstract]Objective To compare the sedative and analgesic effects of Dexmedetomidine in different doses in elderly patients with arthroplasty.Methods A total of 84 elderly patients who underwent arthroplasty in our hospital from April to October in 2017 were divided into three groups according to the stratified randomized method.In combination group（n=28），low loading and maintenance doses of Dexmedetomidine was used.In maintenance group（n=28），a small dose of Dexmedetomidine for maintenance was selected.In the control group （n=28），intravenous infusion of saline was adopted.The sedative and analgesic effects among the three groups were compared.Results In both combination and maintenance groups，the sedation scores after medication and 30 min after medication were lower than those in the control group with statistical differences （P 　　[Key words]Dexmedetomidine；Lderly；Joint replacement；Sedation；Analgesia 　　关节置换术是治疗关节损伤的有效方法之一，近年来已经在临床得到了广泛的认可，疗效可靠。但在手术治疗中，安全有效的麻醉措施也是手术成功的重要保障。特别是对麻醉耐受较差的高龄患者而言，应选择安全有效的麻醉方法[1]。右美托咪定是有效的新型镇静镇痛药，可用于高龄患者手术麻醉，但