右美托咪定复合局麻在眼科手术中的应用  

Application of dexmedetomidine combined with local anesthesia in ophthalmic surgery

作　　者：张斯[1] 付琦[1] 康鑫鑫[1] 王元[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,450052

出　　处：《中华眼外伤职业眼病杂志》2014年第8期624-627,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨不同剂量的右美托咪定在眼科局麻手术中的镇静效果及其安全性。方法眼外伤手术60例，随机分为3组，每组20例。B、c组右美托咪啶负荷剂量0．5μg／kg微量泵〉10min输注，A组等量、等时生理盐水微量泵输注。之后B组以0．3μg／kg／h、C组以0．6μg／kg／h维持至手术结束，A组以等量生理盐水维持至手术结束。记录三组患者血压给药前基础值（T0）、给负荷药量或盐水结束（T1）、给药或盐水30min（T2）、给药或盐水60min（T3）、手术结束（T4）时的镇静评分及收缩压、舒张压、心率、脉搏血氧饱和度（SpO2）的变化。结果三组患者在年龄、身高、体重和手术时间上比较差异无统计学意义。与A组比较，B组、C组Ramsay镇静评分在T1-T4时间点明显升高，差别有统计学意义；各时间点SpO2比较，差异无统计学意义。与T0比较，A组收缩压、舒张压、心率在T1～T4时间点均明显升高，差异有统计学意义；收缩压在B组T1-T4、C组T2～T4均降低，B组、C组心率T1～T4均降低，差异有统计学意义；与A组比较，B、C组收缩压、舒张压、心率在T1～T2时间点均明显降低，差异有统计学意义。结论右美托咪定负荷剂量0．5μg／kg、维持剂量0．3μg／kg微量泵输注，能够为复合局部麻醉提供良好的镇静作用，并安全地应用于眼科手术患者。Objective To evaluate the efficacy and security of different doses of dexmedetomidine on patients undergoing ophthalmic surgery with local anesthesia. Methods Sixty patients with ocular trauma surgery were randomly divided into three groups （20 cases in each group）. Dexmedetomidine in group B and C were administrated with micro-pumps in a loading dose of 0.5 μg/kg over 10 mins, and at the same time, the same amount of normal saline was pumped in the same way in group A. Then dexmedetomidine was pumped as 0.3 μg/kg/h in group B and 0.6 μg/kg/h in group C, and normal saline was maintained in group A until the end of surgery. The Ramsay sedation score, systolic blood pressure（ SBP）, diastolic blood pressure（DBP） , heart rate（HR） , pulse oxygen saturation （ SpO2 ） of the three groups were recorded. The time-points included before the administration（T0 ）, the end of load measurement（T1 ） , 30 min after administration （ T2 ） , 60 min after administration （ T3 ） and the end of operation （ T4 ）. Results There were no significant differences in age, height, weight, operation time and SpO2 at each time point among the three groups. Compared with group A, Ramsay sedation score in group B and group C were significantly higher in T2-T4 time points,and the difference had statistical significance. Compared with TO, the SBP, DBP and HR of group A were much higher in T1 -T4 , and the difference was statistically significant. The SBP decreased in T3-T4 of group B and T2-T4 of group C. The HR of group B and C decreased in T1-T4 , and the difference was statistically significant. Condusion Dexmedetomidine combined with local anesthesia can provide good sedation in ophthalmic surgery with a loading dose of 0.5 μg/kg and maintenance dose of 0.3 μg/kg.

关 键 词：右美托咪定 麻醉 手术 眼科 

分 类 号：R614[医药卫生—麻醉学]