摘要
目的探讨右旋美托咪啶(dexmedetomidine,Dex)对老年患者腰椎术患者的镇静效果分析及血流动力学影响。方法将拟择期行腰椎手术的病人随机分为右旋美托咪定0.5μg组(A组)、1.0μg组(B组)和对照组(C组)。记录患者各时间点的听觉诱发电位指数(A-line ARX-Index,AAI)、有创平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、呼吸频率(respiratory rate,RR)、血氧饱和度(oxygen saturation,SpO2)和改良警觉/镇静视觉评分(observer’s assessment of alert/sedation,OAA/S),并记录术中出现的不良反应。术后24 h随访患者对手术操作的遗忘程度。结果 A、B 2组AAI评分、OAA/S评分、MAP及HR均随着时间的延长呈现不同程度的降低,与C组比较差异有统计学意义。3组RR与SpO2值在各时间点差异无统计学意义。A、B 2组均不能自主正确回忆麻醉及手术过程,经提示后有部分患者可产生回忆;C组大部分患者可不经提示对麻醉及手术过程产生清楚回忆,与A、B2组比较差异具有统计学意义(P<0.01)。A、B组未见恶心呕吐、寒战、呼吸抑制等不良反应,C组多见不良反应发生。结论对老年患者腰椎术的麻醉采用1.0μg/kg Dex给予负荷剂量,按0.5 ug/(kg·h)持续泵入Dex,效果较好。
Objective To investigate the effect of dexmedetomidine(Dex)on sedation and hemodynamics in gerontal patients during lumbar spinal surgery. Methods The undergoing elective lumbar spinal surgery patients were randomly divided into 0. 5 μg Dex group( group A),1. 0 μg Dex group(group B)and control group(group C). Data of mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),oxygen saturation(SpO2),modified observer's assessment of alert /sedation(OAA /S score)and the value of A-line ARX-Index(AAI)were recorded at each time point,as well as the adverse reactions during the operation. Patients were followed up for the surgical operations forgetting degree after postoperative 24 h. Results AAI score,OAA /S score,MAP and HR decreased with the extension of time in group A,B and there was statistically significant difference compared with group C. RR and SpO2 values in three groups showed no significant difference at each time point. There were no patients who could self-correct recall of anesthesia and surgical procedures in A,B groups,and when prompting the recall,some patients could recall the anesthesia and surgical procedures;most patients in group C could clearly recall anesthesia and surgery procedures without prompting,and the difference was significant(P < 0. 01)compared with group A and B. There were no nausea,vomiting,chills and respiratory depression in group A and B,but common adverse reactions occurred in group C. Conclusion The method that anesthesia is induced with 1. 0 μg /kg Dex loading dose,then press 0. 5 ug /(kg·h)continuous infusion of Dex in gerontal patients during lumbar spinal surgery performed well.
出处
《中国生化药物杂志》
CAS
北大核心
2014年第5期135-138,共4页
Chinese Journal of Biochemical Pharmaceutics
基金
2014年承德市科学技术研究与发展计划(自筹经费第一批)项目(20142057)
