摘要
目的观察骨科全麻术前预输注右美托咪定(DEX)对患者麻醉深度及血流动力学的影响。方法选取2018年1月至2019年1月于我院手术治疗的40例骨科手术患者,ASAⅠ~Ⅱ级,随机分为观察组和对照组,两组均在常规全身麻醉下完成手术,观察组患者在麻醉诱导前15 min内泵注DEX,应用剂量为1μg/kg;对照组于相同时间泵入等量生理盐水。对比两组患者T1(入室后)、T2(泵入前5 min)、T3(泵入后)、T4(插管前)、T5(插管后)、T6(切皮时)、T7(术中峰值)、T8(拔管)时血流动力学指标、脑状态指数(Cerebral state index,CSI)、镇静评分(Ramsay);并在T8时使用视觉模拟评分法(VAS)对患者术后疼痛程度进行评分。结果观察组T3~T8时心率均小于对照组(P<0.05),T4、T5、T7、T8时SBP低于对照组(P<0.05),T4、T5、T8时DBP低于对照组(P<0.05);两组各时点SpO2比较差异无统计学意义(P>0.05);观察组T2、T3时CSI值低于对照组(P<0.05),Ramsay评分高于对照组(P<0.05);两组T8时VAS评分比较差异无统计学意义(P>0.05);观察组术中使用丙泊酚注射液及盐酸瑞芬太尼用量均少于对照组(P<0.05)。结论骨科手术患者麻醉诱导前预输注DEX,可提高术中及术后镇静、镇痛效果,减轻患者插、拔管反应,对稳定围术期血流动力学指标具有显著效果。
Objective To observe the effect of pre-injection of dexmedetomidine(DEX)on the anesthesia depth and hemodynamics in patients under general anesthesia underwent orthopedic operation.Methods A total of 40 patients underwent orthopedic operation under general anesthesia with ASAⅠ~Ⅱgrade who were admitted in our hospital from January 2018 to January 2019 were included in the study and randomized into observation group and control group.Patients in the two groups were performed with routine general anesthesia.Observation group was given pump injection of DEX(1μg/kg)at 15 min before anesthesia induction,while control group was given the same amount of saline at the same time.The hemodynamic index,cerebral state index(CSI),and Ramsay score after entering the operation room(T1),5 min before pumping(T2),after pumping(T3),before intubation(T4),after intubation(T5),at the time of skin incision(T6),at peak during operation(T7),and at the time of extubation(T8)in the two groups were compared.VAS was used to evaluate the postoperative pain degree at T8.Results The heart rate at T3~T8 in observation group was significantly lower than that in control group(P<0.05),SBP at T4,T5,T7,and T8 was significantly lower than that in control group(P<0.05),and DBP at T4,T5,and T8 was significantly lower than that in control group(P<0.05).The comparison of SpO2 at each time point between the two groups was not significantly different(P>0.05).CSI at T2 and T3 in observation group was significantly lower than that in control group(P<0.05);Ramsay score at T2 and T3 was significantly higher than that in control group(P<0.05).The comparison of VAS score at T8 between the two groups was not significantly different(P>0.05).The dosage of propofol and remifentanil hydrochloride used during operation in observation group was less than that in control group(P<0.05).Conclusion Pre-injection of DEX in patients undergoing orthopedic operation before anesthesia induction can enhance the intraoperative and postoperative sedation and analgesia effect,alleviate the intubation and extubation reaction,and has a significant effect in stabilizing the perioperative hemodynamic index.
作者
万亮
王小锐
郭文艳
李帛谦
WAN Liang;WANG Xiao-rui;GUO Wen-yan;LI Bo-qian(The Second Hospital of Tangshan City,Tangshan 063000,China)
出处
《实用药物与临床》
CAS
2019年第12期1269-1272,共4页
Practical Pharmacy and Clinical Remedies
基金
河北省2015年度医学科学研究重点课题计划(20150929)
关键词
右美托咪定
骨科
全麻
麻醉深度
血流动力学
Dexmedetomidine
Orthopedics
General anesthesia
Anesthesia depth
Hemodynamics
