右美托咪啶在减轻加压止血带反应中应用临床观察.docVIP

右美托咪啶在减轻加压止血带反应中应用临床观察 　　 摘要：目的： 探讨右美托咪啶在减轻加压止血带反应中应用的临床观察。方法 ：人工膝关节置换术的老年患者60例，年龄65-85岁，体重40-75Kg，随机分为D、C1、C2、C3四组，对照组（D组）和不同剂量右美托咪啶组（C1-3组），四组患者均采用气管内插管静吸复合全麻，C组麻醉诱导前10分钟均输注右美托咪啶0.4ug/kg,随后分别以0.4、0.6、0.8ug/kg/h速率输注至七氟烷麻醉维持停止时。术中记录止血带加压各时点的血压、心率，术中不良事件，麻醉恢复期睁眼时间，拔管时间，Aldrete评分≥9分的时间。结果： 与D组、C1组比较，C2、C3组术中高血压的发生率降低，麻醉苏醒时间减少，差异具有统计学意义（P0.05）。结论：对于人工膝关节置换术老年患者，麻醉诱导前10分钟输注右美托咪啶0.4ug/kg，随后以0.6ug/kg/h速率输注至七氟烷麻醉维持停止，能够有效抑制加压止血带反应，降低了不良反应的发生。 　　关键词：右美托咪啶；止血带反应；老年患者 　　 Abstract:Objective:To explore the clinical observation of dexmedetomidine in alleviating the pressure tourniquet application in reaction.Methods:60 elderly patients with total knee replacement patients, age 65-85 years old, weighing 40-75Kg, were randomly divided into D, C1, C2, C3 four groups, the control group (group D) and different doses of dexmedetomidine group (C1-3 group), four patients were treated with endotracheal intubation general anesthesia, C group 10 minutes before induction of anesthesia were infusion of dexmedetomidine 0.4ug/kg, then respectively by 0.4, 0.6, 0.8ug/kg/h rate of infusion to seven halothane anesthesia maintenance stops. The tourniquet in the time of blood pressure, heart rate were recorded, intraoperative adverse events, anesthesia recovery period time to eye opening, extubation time, Aldrete score ≥ 9 time.Results：compared with D group, C1 group, C2, reduced the incidence of hypertension patients in group C3, anesthesia recovery time is reduced, the difference was statistically significant (P0.05).Conclusion： for the artificial knee joint replacement in elderly patients, 10 minutes before induction of anesthesia infusion of dexmedetomidine 0.4ug/kg, followed by 0.6ug/kg/h infusion rates to seven halothane anesthesia maintenance stop, can effectively restrain the tourniquet reaction, reducing the occurrence of adverse reactions. 　　【中图分类号】R614【文献标识码】A【文章编号】1672-8602(2014)04-0001-02 　　下肢手术通过应用加压止血带，可减少术中出血，并提供良好的视野。但笔者根据临床经验，患者可能出现较为严重的加压止血带反应，尤其是术前血压控制欠佳的患者，从而造成术中血流动力学不稳定。