摘要
目的探讨术前应用右美托咪定对老年患者围术期心率变异性的影响,以及评估是否可以减轻术后疼痛。方法随机选择老年人择期下肢手术患者,符合入选标准54例,分为右美托咪定组与对照组,每组27例。两组患者均采用腰硬联合麻醉,右美托咪定组在入室后静脉泵入右美托咪定0.4μg/kg。记录两组患者给药前(T1)及给药后(T2)心率变异性分析数据、警觉/镇静(Observer assessment of alertness/sedation,OAA/S)评分及术后VAS评分。结果右美托咪定组患者给药后心率变异性分析,低频功率(LF)、高频功率(HF)、低频带与高频带的比值(LF/HF)明显低于给药前,差异有统计学意义(P<0.05)。右美托咪定组给药后,OAA/S评分明显降低,并低于对照组,差异有统计学意义(P<0.05)。右美托咪定组患者术后6 h VAS评分明显低于对照组,差异有统计学意义(P<0.05)。结论术前静脉泵入右美托咪定,可使交感、迷走神经调节的活动性趋于平衡,使血压、心率趋于稳定,减轻患者术后疼痛,利于患者更安全地度过围术期。
Objective To evaluate the effects of preoperative dexmedetomidine on heart rate variability in elderly patients undergoing elective surgery,and assess whether it could relieve post-operative pain.Methods 54 elderly patients undergoing elective surgery were randomized into two groups：dexmedetomidine group and control group,27 cases in each group.The patients of the two groups underwent combined spinal-epidural anesthesia,and patients in dexmdetomidine group received intravenous infusion dexmedetomidine 0.4 μg/kg after entering the operation room.The postoperative VAS score,heart rate variability analysis data and observer assessment of alertness/sedation score（OAA/S）before（T_1）and after administration（T_2）were recorded.Results The mean change in HRV as measured by low frequency（LF）power,high frequency（HF）power,and the LF/HF ratio in dexmedetomidine group decreased after medication,there being significant differences.The OAA/S score in dexmedetomidine group decreased after medication,there being significant difference.The VAS score in dexmedetomidine group was significantly lower than that of control group at 6 h after surgery,there being significant difference.Conclusion Preoperative dexmedetomidine can effectively make the activity of sympathetic and vagus nerve regulation tend to balance,reduce post-operative pain,and it is conductive to patient＇s safety during the perioperative period.
出处
《实用药物与临床》
CAS
2016年第4期436-439,共4页
Practical Pharmacy and Clinical Remedies
基金
辽宁省自然基金课题(2014021023)
关键词
老年患者
围术期
右美托咪定
心率变异性
Elderly patient
Perioperative period
Dexmedetomidine
Heart rate variability
