右美托咪定辅助镇静对行椎管内麻醉的2型糖尿病老年患者术后睡眠状态的影响  

Effect of dexmedetomidine on sedation on the postoperative sleep status of type 2 diabetes elderly patients undergoing spinal anesthesia

作　　者：赵通 马晓静[2] 赵建辉[2] 吕忠立 宋宾强 宋铁鹰[2] 

机构地区：[1]河北省晋州市人民医院麻醉科,河北晋州052260 [2]河北省石家庄市第一医院麻醉科,河北石家庄050011 [3]河北省泊头市人民医院麻醉科,河北泊头062150 [4]河北省元氏县医院麻醉科,河北元氏051130

出　　处：《河北医科大学学报》2016年第11期1298-1301,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20150916)

摘　　要：目的评估右美托咪定辅助镇静对行椎管内麻醉的糖尿病老年患者术后睡眠状态的影响。方法择期椎管内麻醉下行大隐静脉高位结扎和剥脱手术的糖尿病患者40例,采用随机数字表法分为右美托咪定组和对照组各20例。所有患者术前1 d采用匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)评估术前1个月的睡眠情况。腰硬联合麻醉后,右美托咪定组开始持续静脉输注右美托咪定镇静0.2μg·kg-1·h-1,对照组输注等量生理盐水。术中2组均于腰硬联合穿刺完成后即刻(T1)、手术开始1 h(T2)、术毕(T3)时刻抽取静脉血监测血糖。术后1个月所有患者再次采用PSQI评估术后睡眠质量。结果 2组T1~T3时刻血糖值组间、时点间、组间·时点间交互作用差异均无统计学意义(P>0.05)。术前2组PSQI评分差异无统计学意义(P>0.05),术后1个月2组PSQI评分均低于术前,且右美托咪定组低于对照组(P<0.05)。结论右美托咪定辅助椎管内麻醉镇静可在一定程度上改善行椎管内麻醉的糖尿病老年患者术后睡眠状况。Objective To evaluate the effect of dexmedetomidine assisted sedation on the postoperative sleep status of elderly diabetes patients undergoing spinal anesthesia. Methods Forty patients under spinal anesthesia on saphenous vein ligation and stripping elective surgery were randomly divided into two groups（ n = 20） ： dexmedetomidine sedation group（ group D） and control group（ group C）. The sleep quality of last month in all the patients were assessed using the Pittsburgh Sleep Quality Index（ PSQI） the day before operation. When lumbar epidural anesthesia keep stable,group D began continuous intravenous infusion with dexmedetomidine 0. 2 μg · kg^（-1）· h^（-1）,group C with saline infusion. Both groups were blood glucose monitored at three time points： immediately after puncture（ T_1）,one hour after the operation start（ T_2）,at the end of operation（ T_3）. One month later the sleep quality of all the patients were assessed using PSQI once again. Results There was no significant difference incomparison of blood glucose levels between the two groups,between the T_1-T_3 time points,and between the interaction of group · time points（ P〉0. 05）,and no difference in the PSQI scores（ P〉0. 05）,while postoperative PSQI scores in the two groups were lower than that before operation,and the dexmedetomidine group was lower than that of the control group（ P〈0. 05）. Conclusion Dexmedetomidine given spinal anesthesia assist sedation can improve postoperative sleep status of the elderly patients with type 2 diabete to a certain extent.

关 键 词：糖尿病 2型 麻醉 脊椎 右美托咪定 睡眠 

分 类 号：R614.4[医药卫生—麻醉学]