右美托咪定用于椎管内麻醉中清醒镇静的临床观察  

THE CONSCIOUS SEDATION OF THE DEXMEDETOMIDINE ON SPINAL ANESTHESIA

作　　者：袁静[1] 郭长春[1] 李涵葳[1] 

机构地区：[1]暨南大学第二临床医学院,广东深圳518020

出　　处：《现代医院》2011年第11期29-31,共3页Modern Hospitals

摘　　要：目的评价椎管内麻醉中右美托咪定用于清醒镇静的临床效果。方法选择行椎管内麻醉的下肢手术病人40例,ASAⅠ～Ⅱ级,随机分为五组(n=8):椎管内麻醉加静脉输注右美托咪定0.1μg.kg-1.h-1(组Ⅰ)、0.2μg.kg-1.h-1(组Ⅱ)、0.3μg.kg-1.h-1(组Ⅲ)、0.4μg.kg-1.h-1(组Ⅳ)、0.5μg.kg-1.h-1(组Ⅴ)。应用镇静药物30、60、90 min时以改良警觉/镇静观察评分法(OAA/S)和脑电双频谱指数(BIS)记录患者镇静程度,通过看图片记录遗忘程度,同时记录患者对麻醉的满意度。观察术中不良反应,如体动、恶心、呕吐等,并予相应处理。结果与0.1μg.kg-1.h-1组比较,0.2、0.3、0.4、0.5μg.kg-1.h-1四组患者BIS及OAA/S均明显降低(p<0.05)。右美托咪定0.2、0.3、0.4、0.5μg.kg-1.h-1四组的麻醉操作遗忘率分别为50.0%、87.5%、100.0%和100.0%,手术操作遗忘率分别为75.0%、100.0%、100.0%和100.0%。后三组对麻醉过程满意。结论右美托咪定用于椎管内麻醉中清醒镇静可控性好,安全性高,镇静遗忘效果好,0.3μg.kg-1.h-1效果最佳。Objective To observe the clinic effect of Conscious Sedation with dexmede-tomidine on spinal anesthesia. Methods Forty ASA Ⅰ～Ⅱ patients who received operation of lower limbs after spinal anesthesia were randomly divided into five groups（n=8）：Group Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ（the dexmedetomidine was given intravenous injection of 0.1,0.2,0.3,0.4,0.5μg·kg-1·h-1 respectively）.The level of sedation was registered through observer＇s Assessment of alertness sedation scale（OAA/S） and bispectral index（BIS） After infusion of dexmedetomidine 30,60,90mins.The level of oblivion and satisfaction were registered. Results The OAA/S and BIS in group Ⅱ~Ⅴ were less than group I statistically（p0.05）.The forgetting rate of anesthesia with dexmedetomidine in groups Ⅱ,Ⅲ,Ⅳ,Ⅴ were 50%,87.5%,100%,100%.The groups Ⅲ,Ⅳ,Ⅴ were satisfied with anesthesia. Conclusion The conscious Sedation with dexmedetomidine on spinal anesthesia was effective and safe.The dose of dexmedetomidine of 0.3 μg·kg-1·h-1 is better.

关 键 词：清醒镇静 右美托咪定 脑电双频谱仪(BIS) 警觉/镇静评分(OAA/S) 

分 类 号：R614.4[医药卫生—麻醉学]