摘要
目的:探讨观察右美旋托咪啶用于B型主动脉夹层覆膜支架腔内隔绝术中的镇静效果及安全性。方法:局麻复合强化麻醉下行覆膜支架腔内隔绝手术的患者60例,随机分为右旋美托咪啶组(D组)和芬太尼+咪达唑仑组(C组),每组30例,采用静脉注射,给药时间持续10 min,观察给药后即刻(基础值),5 min(T1)、8 min(T2)、10 min(T3)、12 min(T4)、15 min(T5)、20 min(T6)、25 min(T7)及30min(T8)的血压、心率(HR)、呼吸频率、经皮血氧饱和度(SpO2)、脑电双频谱(BIS)值及改良警觉、镇静观察评分变化并记录有无术中不良反应。结果:与基础值比较,D组T3～T8时收缩压(SBP)降低和舒张压(DBP)降低,T3～T8时HR降低,T4～T7时镇静评分降低,T5、T6时BIS值降低;C组T3时SBP降低,T4时镇静评分降低(P<0.05或P<0.01)。与C组比较,D组在T5～T7时SBP降低,在T6、T7时DBP降低,T3～T6时HR降低,T5、T6时镇静评分降低,T5、T6时BIS值降低,发生呼吸抑制及恶心呕吐的发生率降低(P<0.05或P<0.01)。2组各时点呼吸频率(RR)和血氧饱和度(SpO2)比较,差异无统计学意义(P>0.05)。结论:右旋美托咪啶具有良好的镇静效果,对呼吸影响小,不良反应轻微,可安全用于覆膜支架腔内隔绝术中镇静。
Objective：To evaluate the efficacy and safety of dexmedetomidine application during endovascular stent-graft exclusion.Methods：60 patients undergoing endovascular stent-graft exclusion were randomly assigned to dexmedetomidine group（group D,n=30） or fentanyl plus midazolam group（group C,n=30）.Both groups were intravously injected with medication of both groups for 10min.Blood pressure（BP）,heart rate（HR）,respiratory rate（RR）,oxygen saturation（SpO2）,BIS value and OAA/S（Observer＇s Assessment of Alertness-Sedation） scale were evaluated at points of before administration（baseline） and after medication injection 5 min（T1）,8 min（T2）,10 min（T3）,12 min（T4）,15 min（T5）,20 min（T6）,25 min（T7）,30 min（T8） and side effects of the two groups were recorded at the same time.Results： In group D,comparing to baseline,systolic blood pressure（SBP） and diastolic blood pressure（DBP） decreased at T3-T8,HR decreased at T3-T8,OAA/S decreased at T4-T7,BIS decreased at T5-T6;In group C,comparing to baseline,SBP decreased at T3,OAA/S decreased at T4（P0.05 or P0.01）.Comparing to group C,SBP decreased at T5-T7,DBP decreased at T6,T7,HR decreased at T3-T6,OAA/S decreased at T5-T6,BIS decreased at T5-T6 and the incidence of respiratory inhibition and nausea and vomiting were significant different between 2 groups（P0.05 or P0.01）.There were no significant different in RR and SpO2 between 2 groups（P0.05）.Conclusion： Dexmedetomidine can provide satisfied sedation and with lower side effects incidence,is safe and effective to patients undergoing endovascular stent-graft exclusion.
出处
《心肺血管病杂志》
CAS
2012年第2期109-112,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
右旋美托咪啶
腔内隔绝术
镇静
心脏外科手术
Dexmedetomidine
Endovascular stent-graft exclusion
Sedation
Cardiac surgery
