摘要
目的比较布比卡因诱导的蛛网膜下隙阻滞麻醉中静脉给予小剂量氯胺酮或右旋美托咪定两者的镇静效果。方法 90例择期盆部或下肢手术患者被随机分为3组:生理盐水组(NS组)、右旋美托咪定组(D组)和氯胺酮组(K组)。各组患者布比卡因麻醉前静脉给药行镇静诱导,NS组给予生理盐水10 m L,5 m L/h;D组给予右旋美托咪1μg/kg,0.5μg/(kg·h);K组给予氯胺酮0.2 mg/kg,0.5 mg/(kg·h)。记录3组患者感觉阻滞最高水平的时间、感觉运动恢复的时间,血流动力学的变化。结果 K组患者相对于其他2组患者更快地完成了感觉的阻滞,但在最高阻滞节段上3组无明显差异;从感觉回复和屈膝动作出现的平均时间上看,D组和K组患者也明显长于NS组患者所用时间。结论提示氯胺酮和右旋美托咪定在布比卡因诱导蛛网膜下隙阻滞麻醉中镇定作用相似,但从血流动力学表现看氯胺酮要优于右旋美托咪定。
Objective To compare the effects of intravenous ketamine and dexmedetomidine infusion on spinal block with bupivacaine. Methods Ninety patients with scheduled spinal anesthesia were randomly divided into three groups. Normal saline 10 m L（ 5 m L / h） was given to group NS,dexmedetomidine 1 μg / kg [0. 5 μg /（ kg·h） ]was given to group D）,and ketamine 0. 2 mg / kg,0.5 [0. 5 mg /（ kg·h） ]was given to group K. The time to highest sensory block level,sensory and motor regression,and hemodynamic change were recorded. Results Patients in group K had faster onset time of sensory block than patients in group NS and D. There was no significant difference in highest sensory block levels among three groups. Average time of sensory regression and knee flexion was significantly longer in the group K and group D than the group NS. Conclusion Intravenous dexmedetomidine and ketamine are proved to have a similar synergistic effect in subarachnoid block anesthesia with bupivacaine. Hemodynamic stability shows ketamine is better than dexmedetomidine.
出处
《实用临床医药杂志》
CAS
2015年第24期39-41,45,共4页
Journal of Clinical Medicine in Practice
