右美托咪定在心脏术后镇静、镇痛中的应用  

Application of dexmedetomidine in postoperative sedation and analgesia in patients after cardiac surgery

作　　者：姜淑云[1] 许红阳[1] 金科[1] 杨挺[1] 严洁[1] 

机构地区：[1]无锡市人民医院重症医学科,江苏省214023

出　　处：《江苏医药》2014年第6期688-690,共3页Jiangsu Medical Journal

摘　　要：目的探讨右美托咪定对心脏术后患者镇静、镇痛的疗效及安全性。方法 38例心脏术后患者采用右美托咪定负荷量0.5-1.0μg/kg,继以0.2-0.7μg·kg-1·h-1维持,在用药前及用药后10、30、60min记录BP、HR、SpO2、RR和潮气量,并评估镇静程度,观察不良反应。结果 38例均能达到镇静、镇痛目标评分。与用药前比较,用药后BP、HR下降(P<0.05),RR、潮气量及SpO2均无明显变化(P>0.05)。2例收缩压降至90mm Hg,1例发生心动过缓,对症处理后均缓解。结论右美托咪定用于心脏术后患者具有良好的镇静、镇痛作用,不良反应小。Objective To investigate the efficacy and safety of dexmedetomidine in postoperative sedation and analgesia of the patients after cardiac surgery. Methods Dexmedetomidine was intravenously infused in 38 patients after cardiac surgery, which was used in a loading dose of 0.5-1.0μg/kg and 0. 2-0. 7 μg . kg-1 . h-1 for the maintenance. Blood pressure, heart rate, transcutaneous oxygen saturation, respiratory rate, tidal volume, and level of sedation were recorded before and at 10, 30, 60 min during treatment. The adverse reactions were observed as well. Results The goal scores of sedation and analgesia reached in all patients. Compared with before, blood pressure and heart rate were decreased（P〈0. 05）, and respiratory rate, tidal volume and oxygen saturation showed no significant changes during treatment （P〉0. 05）. Systolic blood pressure dropped to 90 mmHg in two patients and bradycardia occurred in one patient, which were relieved after symptomatic treatment. Conclusion Dexmedetomidine has better effect of sedation and analgesia and less adverse reactions in patients after cardiac surgery.

关 键 词：右美托咪定 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]