右美托咪定蛛网膜下腔注射对布比卡因腰麻作用的影响  

Effects of subarachnoid injection of dexmedetomidine on spinal anesthesia with bupivacaine

作　　者：张振华[1] 姜春南[1] 邵钢[1] 韦宁仙[1] 

机构地区：[1]丹阳市人民医院麻醉科,江苏省212300

出　　处：《江苏医药》2016年第2期169-171,共3页Jiangsu Medical Journal

基　　金：镇江市社会发展基金(SH2008051)

摘　　要：目的探讨右美托咪定蛛网膜下腔注射对布比卡因腰麻作用的影响。方法老年良性前列腺增生(BPH)经尿道电切手术患者150例,采用0.75%布比卡因8mg腰麻。腰麻药注射后分别注入右美托咪定2μg(A组,50例)、吗啡0.1mg(B组,50例)和生理盐水1ml(C组,50例)。连续监测MAP和HR,评估腰麻感觉和运动阻滞水平,记录不良反应发生情况。结果三组达到最高感觉和运动阻滞平面的时间相仿(P>0.05)。A、B组感觉和运动阻滞消退时间长于C组(P<0.05),A组短于B组(P<0.05)。不良反应:B组术中低血压、心动过缓和恶心、呕吐的发生率以及术后的皮肤瘙痒和尿潴留发生率均高于A、C组(P<0.05),A、C组的不良反应发生率相仿(P>0.05)。结论与辅用吗啡比较,右美托咪定蛛网膜下腔注射用于老年BPH经尿道电切术患者,能增强布比卡因腰麻作用,不良反应少。Objective To study the effects of subarachnoid injection of dexmedetomidine on spinal anesthesia with bupivacaine.Methods The transurethral resection of the prostate（TURP）under spinal anesthesia with bupivacaine 8 mg was performed in 150 patients（aged ≥65 years old）with benign prostatic hyperplasia（BPH）.The injection of bupivacaine was followed by subarachnoid injection of dexmedetomidine 2 μg（group A,50 cases）,morphine 0.1 mg（group B,50 cases）or normal saline 1ml（group C,50 cases）.The HR and MAP were monitored,the planes of motor and sensory blockade were evaluated and adverse effects were observed.Results The times of reaching the maximal planes of motor and sensory blockade in three groups were similar（P〉0.05）.The fade times of the planes of motor and sensory blockade were longer in groups of A and B than those in group C（P〈0.05）,which were longer in group B than those in group A（P〈0.05）.The incidence rates of intraoperative hypotension,bradycardia,nausea and vomiting,and postoperative skin itch and urinary retention were higher in group B than those in groups of A and C（P〈0.05）,which in groups of A and C were similar（P〉0.05）.Conclusion Compared to morphine,subarachnoid injection of dexmedetomidine 2 μg can effectively enhance the effects of spinal anesthesia with less adverse effects in the elderly with BPH undergoing TURP.

关 键 词：腰麻 右美托咪定 吗啡 老年 

分 类 号：R614[医药卫生—麻醉学]