右美托咪定辅助老年人硬膜外麻醉镇静的临床效果  

Clinical Efficacy of Dexmedetomidine Used in Epidural Sedative Anesthesia for Senile Patients

作　　者：钱静[1] 吉林[1] 袁从虎[1] 陈佩军[1] 

机构地区：[1]江苏省盐城市第三人民医院麻醉科,江苏盐城224100

出　　处：《医学临床研究》2013年第9期1789-1791,共3页Journal of Clinical Research

摘　　要：【目的】探讨右美托咪定辅助应用于老年人和青年人硬膜外麻醉后的镇静、镇痛和抗不良反应效果。【方法】本院2010年6月至2012年3月收治拟行硬膜外麻醉手术的患者60例，ASA评分I～II级，按年龄段分为老年组（60～80岁）和青年组（25～45岁），每组各30例。硬膜外麻醉效果满意后，通过警觉／镇静评分（OAA／S）评估镇静程度，调整右关托咪定的输注速率使OAA／s评分维持1～2分，手术结束后停用右美托咪定。记录患者的麻醉时间、手术时间、停药后呼唤睁眼时间及0AA／s评分达4分和5分的时间；同时观察两组患者预防腹部牵扯反应有效率及术中不良反应发生情况并加以总结分析。【结果】老年组和青年组麻醉时间、手术时间、停药后呼唤睁眼时间及0AA／S评分达4分和5分的时间无明显差异（P〉0．05）；预防腹部牵拉反应有效率方面，两组亦无明显差异（P〉0．05）。【结论】右美托咪定应用于一般情况好的老年人硬膜外麻醉腹部手术有良好的镇静及预防牵拉反应作用，是一种安全有效的麻醉方式。[Objective] To explore the sedative, analgesia and anti-adverse reaction effect of dexmedetomi- dine（Dex） used in epidural anesthesia for senile and young patients. [Methods] Sixty ASA I - II patients scheduled for the operation under epidural anesthesia admitted to our hospital from Jun. 2010 to March 2012 were divided into senile group（60-80 years old, n = 30） and young group（25-45 years old, n = 30） accord- ing to the age. After epidural anesthesia achieved satisfactory effect, alertness/sedation score（OAA/S） was used to assess the sedative level. The transfusion velocity of Dex was adjusted to maintain 1 - 2 scores of OAA/S. After the operation, Dex was stopped. The anesthesia time, operation time, awake time and the time to reach 4 and 5 scores of OAA/S of patients were recorded. The effective rate of preventing abdominal stretch response and the incidence of intraoperative adverse reaction of patients in two groups were observed and ana- lyzed. [Results] There was no significant difference in anesthesia time, operation time, awake time and the time to reach 4 and 5 scores of OAA/S between senile group and young group（ P 〉0.05）. There was no sig- nificant difference in the effective rate of preventing abdominal stretch response between two groups （ P 〉0.05）. [Conclusion] Dex used in epidural anesthesia for elderly patients with good general condition undergo- ing abdominal surgery has good sedative effect and can prevent abdominal stretch response, so it is a safe and effective anesthesia method.

关 键 词：麻醉 硬膜外 右美托咪定 

分 类 号：R614[医药卫生—麻醉学]