右美托咪定复合舒芬太尼静脉麻醉在老年患者眼科手术中的应用.docVIP

摘 統患术 中的删 2018-03-29 10:29:48中国现代医生2018年5期 俞剑琴陈世云陈超巧郁引飞沈丽君 ［摘耍］鬥的觀察不同剂fi的右莢托咪定(DEX)、舒芬太尼(SF)对眼科手术屮老年患者循 环、呼吸系统的影响。方法选择2016年5月?2017年3月40例表面麻醉下行双眼白内障术的老 年患者，年龄60?70岁，ASA II级，双眼手术隔日分次施行，采用自身配对没计方法，手术眼别 采用数字表法随机选择，首次手术为A组(DEX4pg+SF1 pg),隔日手术为B组(DEX8pg+SF 2pg)。观察记录入室后5 min (T1)、表面麻醉时(T2)、手术幵始后10 min (T3)、术后20 min (T4)的平均动脉血压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼吸频率(RR)、呼 气末二氧化碳分压(PEtCO2)、改良Ramsay镇静评分(MSSR)。结果两组患者T1吋点的MAP、 HR比较差异无统计学意义(P0.05) ； A组患者T2、T3、T4吋点的MAP、HR与T1吋点比较差 异无统计学意义(P0.05); B组患者T2、T3、T4时点的MAP、HR明显低于A组同时点(P0.01)。 两组患者各时点的SpO2、RR、PEtCO2、MSSR比较差异无统计学意义(P0.05)。结论单次 静脉注射不同小剂S:的DEX+SF对老年患者的呼吸系统均无不良影响，且产生的镇静效应相似，而 静脉注射不同小剂景的DEX+SF会抑制老年患者循环系统，导致血压、心率下降，影响程度与注射 剂量呈正相关，静脉注射DEX8 pg+SF 2 pg的剂量能产生10%左衣的抑制心血管效应。 ［关键词］右美托咪定；舒芬太尼；静脉麻醉；老年患者；白IAJ障手术 ［ ］R614 ［ ］B ［ ］1673-9701 (2018) 05-0110-04 ［Abstract］ Objective To observe the effects of different doses of dexmedetomidine (DEX) and sufentanil (SF) on circulation and respiration in elderly patients during ophthalmic surgery. Methods 40 elderly patients undergoing bilateral cataract surgery under surface anesthesia, who were aged from 60 to 70 years old， with ASA grade II from May 2016 to March 2017 were selected. Binocular surgery was performed on every other day. Self-matching design method was used. And surgical eyes were randomly selected using the digital table method. The patients with the first surgery were as group A (DEX 4 pg+SF 1 pg) , and the patients with every other day surgery were as group B (DEX 8 pg+SF 2 pg) . The mean arterial blood pressure (MAP) , heart rate (HR) , SpO2, respiratory rate (RR) , end-tidal carbon dioxide (PEtCO2) , modified Ramsay sedation score (MSSR) at 5 min after entering the room (T1) , the time of surface anesthesia (T2) , 10 min after operation (T3) and 20 min after surgery (T4) were observed and recorded. Results There were no significant differences in MAP and HR between the two groups at T1 (P0.05) . There was no significant difference in MAP, HR between T2, T3 and T4 compared with T1 in th