摘要
目的比较右美托咪啶不同用药方案用于日间眼底手术镇静的效果。方法择期日间眼底手术患者50例,年龄20~65岁,ASAⅠ-Ⅱ级,随机分为两组(n=25):A组给与右美托咪啶负荷量0.7μg/kg以及维持剂量0.5μg/(kg·h),B组给与负荷量咪唑安定1.5㎎和舒芬太尼5μg,维持剂量右美托咪啶0.5μg/(kg·h)。手术开始前由术者行球后阻滞,记录患者入室后(T1)、负荷给药后(T2)、球后阻滞后(T3)、手术开始后(T4)、手术开始后(T5)、眼底激光(T6)、手术结束(T7)各时点平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO_(2))、脑电双频指数(BIS)、Ramsay评分及手术结束患者和术者满意度评分、麻醉恢复室Aldrete评分,记录并处理不良反应。结果患者Ramsay评分,B组T2、T4-T6时点显著低于A组(P<0.05);B组T3到T7时点MAP明显低于A组(P<0.05);B组T2及T3时点HR明显高于A组(P<0.05)。患者满意度评分(IOWA评分)B组显著高于A组(P<0.05)。术中BIS,SPO_(2)及术者满意度组间差异无统计学意义。结论低剂量咪唑安定和舒芬太尼复合低剂量右美托咪啶持续泵注用于日间眼底手术镇静效果优于单独使用右美托咪啶,血流动力学更加平稳,镇静深度适宜,患者满意度更高。
Objective To compare the sedative effect of different regimens of dexmedetomidine in day-case ophthalmic surgery.Methods Fifty patients,ASAⅠ-Ⅱ,who underwent elective ophthalmic surgery,were randomly divided into two groups with 25 in each:The dexmedetomidine(group A)and dexmedetomidine midazolam plus sufentanil(group B).In group A,the loading dose of dexmedetomidine was 0.7μg/kg,followed by 0.5μg/(kg·h)dexmedetomidine.In group B,the loading dose was midazolam 1.5 mg and sufentanil 5μg,followed by 0.5μg/(kg·h)dexmedetomidine.Intra-operative heart rate(HR),mean arterial pressure(MAP),bispectral index(BIS),oxygen saturation(SPO_(2))and Ramsay scores,Aldrete score,satisfaction score of patient and surgeon were recorded.Results At T2,T4-T6 time points,the Ramsay scores of group B were lower than that of group A(P<0.05).The MAP was lower in group B than group A at T3-T7 time points;The HR was higher(P<0.05)in group B than group A at T2 and T3 time points.Patient satisfaction was significant different between the twogroups,the IOWA scores of group B was higher than that of group A(P<0.05).There were no significant differences between the two groups in BIS,SPO_(2) and surgeon satisfaction.Conclusions The combination of dexmedetomidine midazolam plus sufentanyl appears to have more advantages in day-case ophthalmic surgery regarding hemodynamic stability,sedation effect and patient satisfaction.
作者
岳建英
李铭
奚春花
YUE Jian-ying;LI Ming;XI Chun-hua(Department of Anesthesiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)
出处
《基础医学与临床》
2022年第7期1108-1112,共5页
Basic and Clinical Medicine
