右美托咪定辅助局部麻醉在眼科手术中的应用  

Clinical study of intravenous dexmedetomidine assisted local anaesthesia in eye surgery

作　　者：张斯[1] 王艳萍[1] 马民玉[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,450052

出　　处：《中国实用医刊》2013年第16期50-52,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨右美托咪定辅助局部麻醉在眼科手术中应用的可行性。方法选择ASAI～Ⅱ级拟行眼科手术患者60例，随机分为两组，右美托咪定组（D组）和对照组（c组），每组30例。D组以右美托咪啶负荷剂量0．5μg／kg微量泵输注，时间〉10min，之后以0．4μg／（kg·h）维持至手术结束。C组给予同等容量的生理盐水微量泵输注至手术结束。记录两组患者给药前（TO）、手术开始时（T1）、手术开始后30min（1、2）、手术开始后60min（T3）、手术结束（T4）时Ramsay、镇痛评分及收缩压（SBP）、舒张压（DBP）、心率（HR）、呼吸频率（RR）的变化。结果Ramsay评分两组间比较，D组在Tl～T4时间点与c组比较差异有统计学意义（P〈0．05）。VAS评分两组间比较，D组在T1～T4时间点与c组比较差异有统计学意义（P〈0．05）。SBP两组间比较，在T1-T4时间点c组显著高于D组，差异有统计学意义（P〈0．05）；组内比较c组T1～T4时间点均高于rm，差异有统计学意义（P〈0．05），DBP两组间比较，在T1-T4时间点c组显著高于D组，差异有统计学意义（P〈0．05），组内比较c组他-T4时间点显著高于11D，差异有统计学意义（P〈0．05）。HR两组间比较，c组T1-T4时间点明显快于D组，差异有统计学意义（P〈0．05），组内比较。c组在T1-T4各时间点较110明显增快，差异有统计学意义（P〈0．05）。两组患者RR比较差异均无统计学意义。结论右关托咪定以负荷剂量O．5μg／kg，〉10min微量泵输注，以0．4μg/（kg·h）剂量维持辅助局部麻醉，可以安全、有效地应用于眼科手术。Objective To investigate the feasibility of intravenous dexmedetomidine assisted local anaesthesia in eye surgery. Methods Sixty patients, ASA I -II undergoing eye surgery were randomly divided into two groups： control group（group C） and dexmedetomidine group （group D） , with 30 cases in each group. The patients in group D received a loading dose of dexmedetomidine （0.5 μg/kg）, infused with micro pump, over 10 minutes, followed by continuous intravenous infusion of dexmedetomidine at 0.4 μg/（ kg h）. The patients in group C received infusion with micro pump of normal saline at the same calculated loading and volume until the operation ended. The analgesic effect was monitored by the VAS, and the sedation effect was monitored by the Ramsay score, heart rate （HR）, blood pressure （BP）, and respiratory rate （RR） were also recorded before drug infusion （T0）, at 0 minutes （T1）, 30 minutes （T2）, 60 minutes （T3） of surgery and at the end of surgery （T4）. Results The patients in group D had significantly higher Ramsay scores and lower mean VAS score, compared with the patients in group C from T1 to T4 （P 〈0.05）. In group C, SBP and DBP were significantly higher at T1 - T4, in comparison to the baseline values. The increases of SBP and DBP from T1 to T4 were different between the groups. Group D had significantly lower heart rates than group C at all time points during the infusion （P 〈 0.05 ）. In group D, HR was significantly lower than the baseline in all measurement times. In group C, all the HR values were higher than the baseline value （P 〈 0.05 ）. There was no significant difference in RR between the two groups. Conclusions Infusion with micro pump of dexmedetomidine at loading dose of 0.5 μg/kg, followed by continuous intravenous infusion of dexmedetomidine at 0.4 μg/（kg h）, can be effective and safe in assisted local anaesthesia of eye surgery.

关 键 词：右美托咪定 局部麻醉 眼科手术 

分 类 号：R614[医药卫生—麻醉学]