麻醉诱导前右美托咪定对妇科手术患者机械痛阈无影响  

No influence of dexmedetomidine on mechanical pain threshold in gynecological patients before induction of anesthesia

作　　者：黄鹏浩 张咪[1] 段光友[1] 郭珊娜 英英[1] 张咸伟[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,430030

出　　处：《实用疼痛学杂志》2016年第1期8-12,共5页Pain Clinic Journal

摘　　要：目的观察麻醉诱导前右美托咪定对妇科手术患者机械痛阈的影响。方法本研究采用双盲测试，随机将妇科手术患者60例分为2组，D组为右美托咪定组，药物浓度为2gg／ml，给药剂量0．7gg／kg（O．35ml／kg）；N组为生理盐水组，0．9％生理盐水的给药剂量为0，35ml／kg，两组控制给药时间均为10min；麻醉诱导前通过静脉途径给药观察对机械痛阈的影响。记录患者3种机械痛测试结果，包括0．1cm。探头及0．01cm。探头的压力性痛阈（PPT），0．1cm。探头的压力性耐痛阈（PTO），Narcotrend指数（NTI），改良OAA／S评分，重要生命体征HR、MAP和SpO2。结果给药后右美托咪定组的机械痛阈测试结果变化差异均无统计学意义，且右美托咪定组和对照组比较差异也没有统计学意义；D组的NTI指数低于N组（76．87±27．21 vs 98．37±1．22，P〈0．05），D组的改良OAA／S评分也低于N组（3．93±0．94vs5．00±0．00，P〈0．05）；尽管给药后两组MAP和SpO2都无显著变化，但D组的心率低于N组（64±8 vs 81±14，P〈0．05）。结论麻醉诱导前右美托咪定给药剂量为0．7μg／kg时，其对妇科手术患者机械痛阈没有影响。Objective To observe the influence of dexmedetomidine on pressure pain threshold in gynecological patients before induction of anesthesia. Methods This study was a double-blind test. Sixty patients were randomly divided into two groups, group D： dexmedetomidine with a dosage of 0.7 μg/kg （0.35 ml/kg） was diluted to 2 μg/kg, and administered within 10 minutes;group N： 0.35 ml/kg of normal saline was injected within 10 minutes. The results of pressure pain threshold （0.1 cm^2 probe and 0.01 cm^2 probe）, pressure pain tolerance threshold （0.1 cm^2 probe） , Narcotrend index （NTI）, modified OAA/S score, and vital signs include HR, MAP and SpO2 were recorded. Results After dexmedetomidine was injected, there were no statistical changes of mechanical pain test, and the similar results in group N was observed. NTI in group D was less than that in group N （76.87±27.21 vs 98.37 ± 1.22, P〈 0.05） , modified OAA/S score in group D was less than that in group N （3.93 ± 0.94 vs 5.00 ± 0.00, P〈 0.00）. HR in group D decreased markedly compared with that in group N （64 ± 8 vs 81 ± 14, P 〈 0.05）. Conclusion Dexmedetomidine does not affect mechanical pain threshold in gynecological patients with the dosage of 0.7 μg/kg before induction of anesthesia.

关 键 词：右美托咪啶 疼痛敏感性 机械痛阈 

分 类 号：R614[医药卫生—麻醉学]