右美托咪定在椎管内麻醉下阑尾切除中减轻牵拉反应应用.docVIP

右美托咪定在椎管内麻醉下阑尾切除中减轻牵拉反应应用 　　【摘 要】目的：研究分析右美托咪定在椎管内麻醉下阑尾切除中减轻牵拉反应的应用。方法：选取在我院进行椎管内麻醉下阑尾切除术的患者150例，分为两组，对照组患者手术前静脉注射咪达唑仑，观察组患者手术前静脉注射右美托咪定至负荷量（10min输注），分析对牵拉反应的影响效果。结果：观察组患者在T0时HR、SpO2、MAP、CSI以及Ramsay镇静评分与对照组相比，差异不显著。在T1、T2、T3时，观察组患者的HR、SpO2、MAP、CSI与对照组相比，差异显著，且P0.05。结论：对进行椎管内麻醉下阑尾切除术的患者采用右美托咪定，能够减轻牵拉反应，并且降低患者的血压和心率。 　　【关键词】右美托咪定；椎管内麻醉下阑尾切除；牵拉反应 　　The application of dexmedetomidine to reduce the traction response in the appendectomy under the anaesthesia of the spinal canal. 　　Zhang Zhaowei（Department of Anesthesiology，second peoples Hospital of Yilong County，Sichuan Nanchong 637631） 　　Abstract Objective： To study and analyze the application of dexmetomidine to reduce the traction response in the appendectomy under the anaesthesia of the spinal canal.Methods：in our hospital were selected on the anesthesia of appendectomy patient 150 cases，divided into two groups，control group patients before the operation，intravenous midazolam intravenous observation group of patients before the operation right beautys microphones set to load （10 min） infusion，analyzed the influence of the reaction to pull effect.Results：compared with the control group，the difference was not significant in the observation group of HR，SpO2， MAP，CSI and Ramsay.At T1，T2 and T3，the HR，SpO2，MAP and CSI of the observation group were significantly different from those in the control group，and P 0.05.Conclusion：right metomidine was used in patients with appendectomy under the anesthesia of spinal canal，which can reduce the traction response and reduce the patients blood pressure and heart rate. 　　Key words：right metomidine； Appendectomy under anesthesia in the spinal canal； Pull reaction 　　【中图分类号】R614.41 【文献标识码】A 【文章编号】1672-3783（2018）06-03--01 　　椎管内麻醉是将药物注入椎管的蛛网膜下腔或硬膜外腔，脊神经根受到阻滞，进而使该神经支配的相应区域受到麻醉作用，是阑尾切除术的常用麻醉方式。内脏的交感纤维来自脊髓交感神经节节后纤维，完全能够被阻滞而丧失功能，但是迷走神经直接发自颅底迷走神经，密集分布与心、肺、纵膈内的脏器组织，其发出的纤维密布与腹腔内的脏器阻滞，椎管内麻醉的阻滞作用无法干涉它们的功能状态，因此在手术过程中会出现牵拉反应和内脏牵拉痛。本次研究在在2017年1月到2017年12月之间，随机选取在我院进行椎管内麻醉下阑尾切除术的患者，分析右美托咪定在椎管内