摘要
目的:探讨右美托咪定在高龄患者围术期麻醉中的应用效果及安全性。方法:选择2017年6月—2019年6月普外科收治的拟行腹部手术高龄患者204例,利用随机数字表法分为对照组和观察组,每组102例。对照组行全身静脉麻醉;观察组在诱导麻醉前给予右美托咪定。记录两组不同时刻血流动力学变化、镇痛镇静效果及不良反应发生情况。结果:与麻醉前10 min(t0)时刻比较,两组切皮后30 min(t1)时刻平均动脉压(MAP)、脑电双频指数(BIS)、心率(HR)明显降低,且观察组MAP,BIS及HR均高于对照组(P<0.05)。手术结束时(t2)时刻两组MAP,BIS及HR较t1时刻均明显升高,但两组间比较,差异无统计学意义(P>0.05)。观察组术后1 h和6 h时视觉模拟评分(VAS)低于对照组,镇静程度(Ras)评分高于对照组(P<0.05);而在术后12 h时,两组患者VAS评分和Ras评分比较,差异无统计学意义(P>0.05),且观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:右美托咪定有利于高龄手术患者血流动力学的稳定,提高镇痛镇静效果和手术安全性。
Objective:To analyze the effect and safety of dexmedetomidine in perioperative anesthesia for elderly patients.Methods:All 204 elderly patients undergoing abdominal surgery in hospital from June 2017 to June 2019 were randomly divided into control group and observation group using random number table method.The control group was given general anesthesia,while the observation group was given dexmedetomidine on the basis of general anesthesia.The hemodynamic changes,analgesic and sedative effects and adverse reactions of the two groups were recorded at different times.Results:Compared with t0 time,the mean arterial pressure(MAP),bispectral index(BIS) and heart rate(HR) of the two groups at t1 time decreased significantly,and MAP,BIS and HR of the observation group were higher than the control group(P<0.05).At t2 time,MAP,BIS and HR of the two groups were significantly higher than that at t1,but there was no significant difference between the two groups(P>0.05).At 1 hour and 6 hours after operation,the visual analogue scale score(VAS) of the observation group was significantly lower than that of the control group(P>0.05),and the rasmay sedation score(Ras) of the observation group was significantly higher than that of the control group(P<0.05),but there was no significant difference in VAS score and Ras score between the two groups 12 hours after operation(P>0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group,there was significient difference(P<0.05).Conclusion:Dextrometridine assisted general anesthesia has a good analgesic and sedative effect,and is safe and reliable.
作者
齐宇珩
陶晓三
杨明敏
QI Yuheng;TAO Xiaosan;YANG Mingmin(The First Hospital of Nanchang,Nanchang 330006,China)
出处
《临床医药实践》
2020年第8期579-582,共4页
Proceeding of Clinical Medicine
基金
2016年江西省卫生计生委科技计划项目(项目编号:20167015)。
关键词
右美托咪定
全身麻醉
镇静
不良反应
dexmedetomidine
general anesthesia
sedation
adverse reactions
