不同速率输注右美托咪定对老年白内障手术患者的镇静效应  

Sedative effect of dexmedetomidine administered at different infusing rates in senile cataract patients

作　　者：任燕伶[1] 张卫[1] 李志松[1] 张豪勇[1] 田丹丹[1] 常琰子[1] 

机构地区：[1]郑州大学第一附属医院麻醉科河南省高等院校医学重点实验室,郑州市450052

出　　处：《临床麻醉学杂志》2012年第1期31-33,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察不同速率输注右美托咪定对老年白内障手术患者球后神经阻滞麻醉下的镇静效应。方法选择90例60～80岁白内障手术患者,根据应用右美托咪定维持剂量随机均分为右美托咪定Ⅰ组(0.2μg·kg-1·h-1)、Ⅱ组(0.4μg·kg-1·h-1)、Ⅲ组(0.6μg·kg-1·h-1)。观察并记录三组患者麻醉前(T0)、神经阻滞完毕即刻(T1)、用药后10min(T2)、20min(T3)、30min(T4)、60min(T5)的Ramsay评分和MAP、HR、RR、SpO2。结果 T2～T5时各组Ramsay评分高于T0时(P<0.05),T3～T5时Ⅲ组高于Ⅰ组(P<0.05)。T3～T5时三组HR显著慢于T0时(P<0.05),以Ⅲ组减慢最明显;T3～T5时三组RR均慢于T0时,但差异无统计学意义;三组间MAP、SpO2差异无统计学意义。结论静注右美托咪定0.5μg/kg后以0.2～0.4μg·kg-1·h-1维持适合老年白内障手术患者的清醒镇静。Objective To observe the sedative effect of dexmedetomidine in senile cataract patients with retrobulbar nerve block. Methods Ninety patients, ASAⅡ orⅢ, aged 60 to 80 years otd,.4cheduled for senile cataract with retrobulbar nerve block were equally randomized into three groups（depending on the maintenance dose of dexmedetomidine） ： group Ⅰ （0.2μg. kg-1. h-1 ）,group Ⅱ （0.4μg.kg-1 .h-l） and group Ⅲ （0.6μg-kg-1.h 1）. Ramsay score and MAP, HR, RR, SpO2 were recorded before anesthesia, after retrobulbar nerve block, and 10, 20, 30, 60 min after sedative administration. Results Ramsay scores were higher in each group at T2-Ts than that at To （P〈0.05） and higher in group Ⅲ than group I at T3-T5 （P〈0. 05）. Heart rate was slower in each group at T3- T5 than that at To （P〈0.05）, in which group Ⅲ was the most. RR of the three groups at T3-T5 decreased compared with that at To, but there were no significant changes in MAP, RR and SpO2 among them. Conclusion Bolus infusion dexmedetornidine 0.5μg/kg followed by intravenous infusion at 0. 2-0.4μg.kg 1 .h-1 is siutable for sedation of elderly patients with cataract surgery.

关 键 词：右美托咪定 镇静 球后神经阻滞 

分 类 号：R614[医药卫生—麻醉学]