右美托咪定对老年腰硬联合麻醉的镇静效果观察.docVIP

右美托咪定对老年腰-硬联合麻醉的镇静效果观 方传奇(河南商丘第一人民医院476000) 目的：观察右美托咪定对老年腰-硬联合麻醉的镇静效果。方法： 将来我院就诊的ASA II级或ASAIII级拟行腰-硬联合麻醉的患者120例作为研究对 象，随机分为空白对照组(A组)、丙泊酚组(B组)和右美托咪定组(Cl、C2、 C3组)。记录患者麻醉前(T1)、腰-硬联合麻醉后(T2)、用药后5min(T3)、15min(T4)、 30min(T5)、60min(T6)的 HR、MAP、SpO2、RR 和 Ramsay 评分，手术后 24h 对患 者进行随访，询问患者用药后到手术结束前对于有关操作的遗忘程度。结果：用 药后5min开始，右美托咪定组所有患者和丙泊酚组患者(B组)的Ramsay评分 比麻醉前要高(Plt;0.05),用药后T4-T6,右美托咪定组中C2、C3以及B组明 显高于A组(Plt;0.05)。用药后T5、T6使B组的MAP比其他组低(Plt;0.05)。 T4、T5、T6时D3组的HR比其他组慢(Plt;0.05)。术后24h随访患者,右美托 咪定组顺行性遗忘程度比空白对照组高(Plt;0.05),和丙泊酚组(B组)差异无 统计学意义。结论：对老年腰-硬联合麻醉患者静脉注射右美托咪定0.5mu;g/kg 后再输注0.2-0.5mu;g?kg-l?h-l镇静效果更好。 关键词 右美托咪定老年腰-硬联合麻醉镇静效果 R614 A 1672-5085 (2014) 11-0085-02 [Abstract] Objective: To observe the sedative effect of dexmedetomidine in aged patients with combined spinal epidural anesthesia (CSEA). Methods:120 patients, ASA 11 o r ASAIII, scheduled for with CSEA, were equally randomized into five groups: control group (group A), propofol group (group B) and dexmedetomidine group (Cl, C2, C3 groups), and MAP, HR, RR, SpO2 and Ramsay score were recorded before anesthesia, after CSEA, and 5,15, 30 and 60 min after sedative administration, All patients were followed up 24 h postoperatively to observe the amnestic effect during operation. Results: Ramsay scores were higher in Cl, C2, C3, B groups at T3-T6 than at T1 (Plt;0.05). Ramsay scores were higher in C2,C3, B groups than A group at T4-T6 (Plt;O.O5). HR decreased in C3 group than other grous at T4-T6 ( Plt;0.05). MAP decreased in B group than other groups at T5 and T6 (Plt;0.05). Amnestic effects in dexmedetomidine groups were higher comparing to A group (Plt;0.05), while had no difference comparing to B group. Conclusion: Dexmedetomidine 0.5mu;g/kg followed by 0.2-0.5mu;g?kg-l?h-lintravenous infusion caused effective sedation and amnestic effect during operation for aged patients with CSEA with no respiratory depression and cycle inhibition. Key words Dexmedetomidine Combined Spinal Epidural Anesthesia (CSEA) Sedative