摘要
目的观察盐酸右美托咪啶在臂丛神经及椎管内阻滞麻醉中的镇静及镇痛效果。方法选择美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级、术前未使用任何镇静及镇痛药物的臂丛神经及椎管内阻滞麻醉患者100例,随机分为盐酸右美托咪定组(观察组)和度氟合剂(哌替啶50 mg、氟哌啶醇5 mg)组(对照组),各50例。待臂丛神经或椎管内阻滞麻醉完善、镇痛完全后,观察组予右美托咪定1.0μg/kg,10 min静脉滴注完毕;对照组予度氟合剂半剂(5 mL),5 min静脉缓注,分别测定用药前,用药后10、30、60 min两组患者脑干听觉诱发电位指数(AAI)、平均动脉压、心率及用药前和用药后30 min血皮质醇含量。结果两组患者用药后AAI、平均动脉压、心率及血皮质醇含量均较用药前降低(P<0.05)。结论盐酸右美托咪啶在剂量选择适宜的条件下(1.0μg/kg)与度氟合剂(半剂量)的镇静及镇痛效果相同或相似。建议在正确掌握适应证并充分考虑患者经济承受力的情况下可使用盐酸右美托咪啶。
Objective To observe the effect of sedation and analgesia of dexmedetomidine in brachial plexus block and spinal eanal block anesthesia. Methods According to Society of Anesthesiologists （ASA） classification, 100 patients with braehial plexus block and spinal canal block anesthesia in grade I or grade lI without any sedative or analgesic drugs before operation were selected and randomly divided into dexmedetomidine hydroehloride group （observation group, n=50） and fluorine mixtures group （pethidine 50 mg, haloperidol 5 mg, control group, n=50）. After full sedation and analgesia in brachial plexus block and spinal canal block, the observation group was with dexmedetomidine 1.0 Ixg/kg for 10-mintue intravenous drip,while the control group was with half of fluorine mixture （5 mL） for 5-minute intravenous slow drip, and then to determine the auditory evoked po- tential （AAI）, mean arterial pressure （MAP） and heart rate （HR） before the medication and at 10,30 and 60 rain after medica- tion,meanwhile to determine the content of blood cortisol 30 minutes after mediction. Results The AAI, MAP, HR and blood cortisol after medication in the two groups were lower than those before medication （P〈0.05）. Conclusion Dexmedetomidine hydrochloride with the proper dosage （ 1.0 μg/kg） has the same or similar effect of sedation and analgesia with fluorine mixtures （half dosage）. It is recommended to eorrectly master the indieations and give full consideration to the patients＇ eeonomic affordability before application of dexmedetomidine hydroehloride.
出处
《现代医药卫生》
2014年第2期169-170,173,共3页
Journal of Modern Medicine & Health
基金
四川省卫生厅科研课题(110592)
关键词
右美托咪啶
镇痛
麻醉
镇静镇痛效果
Dexmedetomidine
Analgesia
Anesthesia
Sedation and analgesia effect
