右美托咪定在硬膜外麻醉下俯卧位肛门部手术中的应用  

Use of dexmedetomidine in patients with epidural anesthesia in prone position undergoing anal surgery

作　　者：韦战红[1] 吕华燕 杜光生[1] 

机构地区：[1]浙江省金华市中心医院麻醉科,浙江金华321000

出　　处：《中国现代医生》2012年第14期91-92,94,共3页China Modern Doctor

摘　　要：目的评估右美托咪定用于硬膜外麻醉下俯卧位肛门部手术的镇静效果及其安全性。方法选择ASAⅠ或Ⅱ级择期行硬膜外麻醉下俯卧位肛门部手术的患者40例,随机分为右美托咪定组(A组)和生理盐水对照组(B组)。A组患者在硬膜外麻醉成功后给予右美托咪定负荷剂量0.5μg/kg(给药时间为15 min)及0.5μg/(kg.h)的维持量;B组以同等方法泵入生理盐水。术中监测循环、呼吸变化,术毕停药前对患者镇静深度作出评分。结果 A组心率、血压下降程度均高于B组(P<0.05)。两组各时点RR、SpO2差异无统计学意义。术毕镇静深度A组较B组深(P<0.05)。结论右美托咪定用于硬膜外麻醉下俯卧位肛门部手术可以产生良好的镇静而无呼吸抑制作用,可以安全地应用于该类手术的镇静。Objective To evaluate the effect and safety of dexmedetomidine （DEX） sedation in patients with epidural anes- thesia in prone position undergoing anal surgery. Methods Forty ASA Ⅰ -Ⅱ patients undergoing anal surgery with epidu- ral anesthesia in prone position were enrolled in this study. The patients were randomly divided into two groups. Group A： The patients were injected with dexmedetomedine at the rate of 0.5 μg/kg as a load dosage within 15 minutes after epidu- ral anesthesia, followed by the rate of 0.5 μg/（kg·h） as the maintenance dose. Group B： Normal saline was given at the same rate in the correspondingly periods of time. Non-invasive blood pressure （NIBP）, heart rate （HR）, respiratory rate （RR） and pulse oxygen saturation （SpO2） were recorded. Ramsay was used to evaluate the effect of dexmedetomidine sedation be- fore stopping infusion. Results HR and NIBP were significantly lower in Group A than those in Group B （P 〈 0.05）; There were no significant differences in RR and SpO2 at every time points between two groups. The effect of sedation was better in Group A than that in Group B （P 〈 0.05）. Conclusion Dexmedetomidine produces good effect of sedation without respi- ratory suppression, so it can be safely used in patients with epidural anesthesia in prone position during anal surgeries.

关 键 词：右美托咪定 硬膜外麻醉 俯卧位 肛门部 

分 类 号：R614[医药卫生—麻醉学]