右美托咪定用于盆底重建术中镇静遗忘作用的观察  

Clinical observation of the sedation and amnesia effect of dexmedetomidine on pelvic floor recon- struction

作　　者：张艳 刘文领 

机构地区：[1]广东省江门市五邑中医院,529000

出　　处：《中国实用医刊》2014年第8期45-47,共3页Chinese Journal of Practical Medicine

摘　　要：目的观察右美托咪定在腰硬联合麻醉下行盆底重建术患者中的镇静及遗忘作用。方法选择5JD例45～65岁、ASAI～Ⅱ级拟在腰硬联合麻醉下行盆底重建术的女性患者，随机分为右美托咪定组（D组）和空白对照组（c组），每组25例。记录麻醉前（T）、麻醉后（TO）、用药后10min（T1）、30min（12）、45min（T3）、60rain（T4）及术毕时（T5）的平均动脉压（MAP）、基础心率（HR）、呼吸频率（RR）、血氧饱和度（SpO，）、Ramsay评分，术后24h随访并记录患者用药后至手术结束对有关操作的遗忘程度。结果T1～T5时D组Ramsay评分显著高于C组（P〈0．05）。T1～T5时D组MAP、HR低于c组（P〈0．05）。RR、低氧血症发生率两纽比较差异无统计学意义（P〉0．05）。术后24h随访，D组患者对手术操作的遗忘程度明显高于C组（P〈0．01）。结论右美托咪定辅助应用于腰硬联合麻醉下盆底重建术中的镇静效果优越，呼吸抑制作用小，且有一定的顺行性遗忘，是一种安全有效的镇静药物。Objective To observe the sedation and amnesia effect of dexmedetomidine on com- bined spinal-epidural anesthesia in patients with pelvic floor reconstruction. Methods Fifty female pa- tients with 45 to 65 years old, ASA I - II scheduled for pelvic reconstructive surgery under combined spi- nal-epidural anesthesia, were randomly divided into two groups （n = 25） ： dexmedetomidine group （D group）, blank control group （group C） MAP, HR, RR and Sp02, Ramsay score was recorded before anesthesia （T）, after corn-bined spinal-epidural anesthesia （TO）, 10 rain （T1）, 30 rain （T2）, 45 rain （T3） , 60 min （3？4） after the treatment and at the end of operation （ T5 ）, and the forgetting degree of related procedure from medi- cation to the ending of the operation during the 24 h follow-up was recorded. Results Ramsay score was significantly higher at T1 -5 in group D than that in group C （P 〈 0. 05）. MAP, HR levels were lower at T1 - 5 in group D than those in group C （ P 〈 0.05 ）. There were no significant differences in RR, the incidence of hypoxemia between the two groups （P 〉 0. 05 ）. During the 24 h follow-up after operation, patients in group D had higher forgetting degree of operation than group C （ P 〈 0. 01 ）. Conclusions Dexmedetomidine auxiliary used in combined spinal-epidural anesthesia for reconstruction of pelvic floor is superior in sedation effect, has little respiratory depression effect, and certain anterograde amnesia, is a safe and effective sedation.

关 键 词：右美托咪定 腰硬联合麻醉 盆底重建术 镇静遗忘 

分 类 号：F431.3[经济管理—产业经济]