右美托咪定在局部麻醉下颈椎后路手术中的应用  

Application of dexmedetomidine in cervical spinal operation by posterior approach under local anesthesia

作　　者：邓莉[1] 嵇富海[1] 杨建平[1] 

机构地区：[1]苏州大学附属第一医院麻醉科,江苏省215006

出　　处：《江苏医药》2014年第7期825-827,共3页Jiangsu Medical Journal

摘　　要：目的评价右美托咪定在局部麻醉下颈椎后路手术中的镇静效果。方法将42例行颈椎后路手术的患者随机均分为两组:D组术前泵注右美托咪定0.5μg/kg,继以0.3μg·kg-1·min-1维持至术毕;C组给予等量生理盐水。记录入室后5min(T0)、切皮前(T1)、切皮后(T2)、手术开始后1h(T3)、2h(T4)及缝皮时(T5)的HR、MAP和SpO2。记录D组患者Ramsay评分。观察术中降压药物的使用以及患者的配合程度,记录术后2h的VAS疼痛评分。结果 D组T1-T5时HR和MAP均低于C组(P<0.05)。与C组相比,D组降压药使用少(P<0.01),患者配合程度高(P<0.01),术后2h的VAS评分低(P<0.05)。结论右美托咪定在颈椎后路手术中可提供充分镇静,减轻术后疼痛,无呼吸抑制等不良反应。Objective To evaluate the efficiency of dexmedetomidine for sedation during cervical spinal operation via posterior approach under local anesthesia. Methods Forty-two patients were equally randomized into two groups of D（received dexmedetomidine 0. 5μg/kg for 10 min as a loading dose,followed by a continuous infusion at 0. 3 μg·kg^-1·min^-1） and C（received equal volume of normal saline）. The changes of MAP, HR and SpO2 were recorded on arrival at operating room （TO） ,before skin incision（T1）, at skin incision（T2）, in 1 hour after incision（T3）, in 2 hours after incision（T4） and at skin suture（T5）. Ramsay sedation scale of group D was evaluated and the amount of antihypertensive drugs, coordination of the patients, and VAS pain score in 2 hours after operation were measured. Results The values of MAP and HR at T1 to T5 were lower in group D than those in group C（P〈0. 05）. Compared with group C, the patients required less antihypertensive treatment （P〈0. 01 ） and showed more coordination （P〈0. 01）, and VAS score was lower in group D （P〈0. 05）. Conclusion Dexmedetomidine as a supplement to local anesthesia for cervical spinal operation can effectively provide better sedation and reduce postoperative pain without respiratory depression.

关 键 词：右美托咪定 镇静 颈椎手术 

分 类 号：R614[医药卫生—麻醉学]