右美托咪定对老年患者腰-硬联合麻醉的镇静效应  

Sedative effect of dexmedetomidine in aged patients with combined spinal epidural anesthesia

作　　者：刘玲[1] 纪风涛[1] 刘付宁[1] 梁建军[1] 曹铭辉[1] 

机构地区：[1]中山大学附属第二医院麻醉科,广州510120

出　　处：《临床麻醉学杂志》2011年第1期49-51,共3页Journal of Clinical Anesthesiology

基　　金：广东省自然科学基金资助项目(No.7001595)

摘　　要：目的观察右美托咪定对老年腰-硬联合麻醉(CSEA)的镇静效应。方法选择100例65～79岁、ASAⅡ或Ⅲ级拟行CSEA的患者,随机均分为右美托咪定组(D1、D2、D3组)、丙泊酚组(P组)和空白对照组(C组)五组。记录麻醉前(T0)、CSEA麻醉后(T1)及用药后5min(T2)、15min(T3)、30min(T4)、60min(T5)的MAP、HR、RR、SpO2和Ramsay评分。术后24h随访患者用药后至结束手术前对有关操作的遗忘程度。结果 T2～T5时,D1、D2、D3、P组Ramsay评分高于T0时(P<0.05),T3～T5时D2、D3、P组显著高于C组(P<0.05)。T4、T5时P组MAP低于其他各组(P<0.05)。T3～T5时D3组HR慢于其他各组(P<0.05)。术后24h随访,D1、D2、D3组顺行性遗忘程度高于C组(P<0.05),与P组相比差异无统计学意义。结论静注右美托咪定0.5μg/kg后以0.2～0.5μg.kg-1.h-1输注适合老年患者CSEA的镇静。Objective To observe the sedative effect of dexmedetomidine in aged patients with combined spinal epidural anesthesia（CSEA）.Methods One hundred patients,ASA Ⅱor Ⅲ,aged 65 to 79 years,scheduled for with CSEA,were equally randomized into five groups：D1,D2,D3 groups,propofol group（group P）,and control group（group C）.MAP,HR,RR,SpO2 and Ramsay score were recorded before anesthesia,after CSEA,and 5,15,30 and 60 min after sedative administration.All patients were followed up 24 h postoperatively to observe the amnestic effect during operation.Results Ramsay scores were higher in D1,D2,D3,P groups at T2-T5 than at T0（P〈0.05）.Ramsay scores were higher in D2,D3,P groups than C group at T3-T5（P〈0.05）.Heart rate decreased in D3 group than other groups at T3-T5（P〈0.05）.MAP decreased in P group than other groups at T4 and T5（P〈0.05）.Amnestic effects in dexmedetomidine groups were higher comparing to C group（P〈0.05）,while had no difference comparing to P group.Conclusion Dexmedetomidine 0.5 μg/kg followed by 0.2-0.5μg·kg^-1·h^-1 intravenous infusion caused effective sedation and amnestic effect during opeartion for aged patients with CSEA with no respiratory depression and cycle inhibition.

关 键 词：右美托咪定 镇静 老年 

分 类 号：R614[医药卫生—麻醉学]