摘要
目的:探讨不同给药剂量右美托咪定滴鼻在老年患者全身麻醉术中的应用。方法:将2023年1月至2023年9月在玉溪市人民医院择期行全身麻醉手术的60例老年患者纳入研究,随机分为A组(给药剂量为0.5μg/kg)、B组(给药剂量为0.8μg/kg)和C组(给药剂量为1.0μg/kg),每组20例,各组患者均在麻醉诱导前30 min使用右美托咪定滴鼻。比较3组患者各时间点平均动脉压(MAP)、心率(HR)及心率-血压乘积(RPP),以及唤醒时间、拔管时间、麻醉后监测治疗室(PACU)留观时间、拔管质量评分、Ramsay等级及心率减慢情况等。结果:A组患者在诱导插管和气管拔管时的MAP、HR和RPP波动较大,且拔管时出现呛咳等不良反应。B组和C组的生命体征较平稳,拔管质量评分较高,C组的Ramsay等级显著高于A组和B组,但C组患者术后出现嗜睡情况,PACU留观时间延长。结论:对于择期行全身麻醉的老年患者,麻醉诱导前30 min给予0.8μg/kg右美托咪定滴鼻,可有效抑制诱导插管和气管拔管时的应激反应,同时不良反应较少,适合临床麻醉中应用。
Objective:To explore the application of intranasal dexmedetomidine at different doses in elderly patients during general anesthesia.Methods:A total of 60 elderly patients undergoing elective surgery under general anesthesia at People's Hospital of Yuxi City from January to September 2023 were randomly divided into three groups:Group A(0.5µg/kg),Group B(0.8µg/kg),and Group C(1.0µg/kg),with 20 patients in each group.Intranasal dexmedetomidine was administered 30 minutes prior to anesthesia induction in all groups.Mean arterial pressure(MAP),heart rate(HR),and rate pressure product(RPP)were measured at different time points.Awakening time,extubation time,postanesthesia care unit(PACU)stay duration,extubation quality scores,Ramsay sedation scores,and incidences of bradycardia were also compared.Results:In Group A,MAP,HR,and RPP were significantly increased during induction intubation and tracheal extubation,with adverse reactions such as coughing during extubation.Groups B and C exhibited more stable vital signs and higher extubation quality scores.Notably,the Ramsay sedation score in Group C was significantly higher than in Groups A and B,but Group C also showed postoperative drowsiness and prolonged PACU stay.Conclusion:Administering intranasal dexmedetomidine at 0.8µg/kg 30 minutes prior to anesthesia induction effectively suppresses stress responses during intubation and extubation in elderly patients undergoing elective general anesthesia.This dose demonstrates minimal adverse effects and is suitable for clinical application in anesthesia management.
作者
原见春
曹波
苏丽红
周云
Yuan Jianchun;Cao Bo;Su Lihong;Zhou Yun(Department of Anesthesiology,People′s Hospital of Yuxi City,Yuxi,Yunnan 653100,China;Department of Emergency,Yuxi Municipal Hospital of T.C.M.,Yuxi,Yunnan 653100,China)
出处
《大理大学学报》
2025年第8期62-66,共5页
Journal of Dali University
关键词
右美托咪定滴鼻
老年患者
全身麻醉
intranasal dexmedetomidine
elderly patients
general anesthesia
