右美托咪定在老年经尿道前列腺电切术中的应用  

Value of dexmedetomidine to transurethral resection of the prostate in the elderly patients

作　　者：郭松青[1] 胡乃琴[1] 严蓉[1] 

机构地区：[1]苏北人民医院麻醉科,江苏扬州225001

出　　处：《中华实用诊断与治疗杂志》2015年第1期95-97,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨右美托咪定在老年经尿道前列腺电切术中的应用价值。方法择期腰硬膜联合麻醉下行经尿道前列腺电切术患者60例,随机分为右美托咪定组和对照组各30例,右美托咪定组于术前15min缓慢静脉泵注负荷剂量右美托咪定0.6μg/kg,然后以0.3μg/(kg·h)泵注维持;对照组静脉泵注相同容量生理盐水,2组均于手术结束前10min停止泵注。比较2组泵注药物前(T1)、泵注药物后15min(T2)、手术15min(T3)、手术30min(T4)、术毕(T5)、术后30min(T6)心率、平均动脉压和Ramsay镇静评分,术后24h寒战发生率及麻醉满意度。结果右美托咪定组T3、T4、T5时间点心率((67.2±8.3)、(60.2±6.5)、(70.3±8.2)次/min)、平均动脉压((75.2±10.5)、(73.3±11.2)、(75.6±12.5)mm Hg)均低于对照组((79.1±11.0)、(79.6±9.8)、(75.7±8.8)次/min和(91.1±12.6)、(87.2±13.5)、(89.5±12.9)mm Hg)(P<0.05);右美托咪定组T2、T3、T4、T5、T6时间点Ramsay镇静评分(3.1±0.5、3.8±0.6、4.1±0.5、4.2±0.5、3.5±0.3)高于对照组(2.0±0.1、1.9±0.2、1.8±0.1、1.8±0.2、2.0±0.1)(P<0.05);右美托咪定组术后寒战发生率(10.0%)低于对照组(30.0%)(P<0.05),麻醉满意度评分(96.36±3.21)高于对照组(90.58±4.65)(P<0.05)。结论老年经尿道前列腺电切术中应用右美托咪定镇静效果满意,可降低术后寒战发生率,增加患者满意度。Objective To investigate the valve of dexmedetomidine to the transurethral resection of the prostate（TURP）in the elderly patients.Methods Sixty patients receiving TURP under combined spinal-epidural anesthesia were randomly divided into dexmedetomidine group and control group,with 30 patients in each group.Dexmedetomidine group received intravenous infusion of dexmedetomidine in a loading dose of 0.6μg/kg within 15 minutes before surgery,followed by 0.3μg/（kg·h）.Control group received intravenous infusion of normal saline with the same dose.Both groups were stopped infusion 10 minutes before the end of surgery.The heart rate,mean arterial pressure and Ramsay sedation score were compared at the time points of before drug infusion（T1）,15 minutes after infusion（T2）,15 minutes after the beginning of operation（T3）,30 minutes after the beginning of operation（T4）,after the operation（T5）,and 30 minutes after the end of operation（T6）between two groups.The incidence of postoperative shivering and patients satisfaction were recorded 24 hours after operation in two groups.Results The heart rates were（67.2±8.3）,（60.2±6.5）,and（70.3±8.2）beats/min,the mean arterial pressures were（75.2±10.5）,（73.3±11.2）and（75.6±12.5）mm Hg at T3,T4 and T5in dexmedetomidine group,lower than those in control group（（79.1±11.0）,（79.6±9.8）,（75.7±8.8）beats/min;（91.1±12.6）,（87.2±13.5）,（89.5±12.9）mm Hg）（P〈0.05）.Ramsay sedation scores were higher in dexmedetomidine group than those in control group at the time points of T2（3.1±0.5 vs 2.0±0.1）,T3（3.8±0.6 vs1.9±0.2）,T4（4.1±0.5 vs 1.8±0.1）,T5（4.2±0.5 vs 1.8±0.2）and T6（3.5±0.3 vs 2.0±0.1）（P〈0.05）.The incidence of postoperative shivering was lower and satisfaction score was higher in dexmedetomidine group（10.0%,96.36±3.21）than that in control group（30.0%,90.58±4.65）（P 0.05）.Conclusion The application of dexmedetomidine in TURP in elderly patients,can achieve

关 键 词：腰-硬联合麻醉 经尿道前列腺电切术 右美托咪定 

分 类 号：R614[医药卫生—麻醉学]