右美托咪定复合地佐辛在淋巴静脉吻合术中的应用  

Effects of Dexmedetomidine Combined with Dezocine in Lymphaticovenous Anastomosis

作　　者：王劭恒[1] 冯枫[1] 沈黎红[1] 关雷[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院麻醉科,北京100038

出　　处：《中国实验诊断学》2016年第9期1499-1501,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的观察右美托咪定(DEX)复合地佐辛用于局部麻醉下淋巴静脉吻合术的有效性及安全性。方法选择局麻下上肢淋巴静脉吻合术成年患者42例,ASA分级为I或Ⅱ级,给予DEX、地佐辛治疗。记录患者入室开通静脉通路时(T0)、DEX泵入负荷量结束时(T1)、术区局麻时(T2)、切皮时(T3)、淋巴管静脉吻合时(T4)、停用右美托咪定时(T5)、缝皮时(T6)、术毕(T7)的收缩压(SBP)、舒张压(DBP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2),以及VAS评分、Ramsay评分、术后询问外科医生、患者满意程度以及患者术中记忆情况。结果患者术中(T1-6)收缩压、舒张压、心率较基础值(T0)降低(P<0.05);术毕时(T7)收缩压、舒张压、心率恢复与基础值无统计学差异(P>0.05);患者手术全程血氧饱和度无明显降低(P>0.05);Ramsay镇静评分,术中较基础值明显增高(P<0.05),至手术结束时Ramsay评分仍略增高(P<0.05)。外科医生及患者对该麻醉方式均有较高满意度。结论 DEX应用于淋巴静脉吻合术中,具有良好镇静、镇痛、遗忘效果,保持血流动力学平稳,安全有效。Objective To investigate the effectiveness and safety of dexmedetomidine（DEX）combined with dezocine in lymphaticovenous anastomosis.Methods 42 adult patients undergoing lymphaticovenous anastomosis with dexmedetomidine combined with dezocine local anesthetic infiltration,were recruited,ASA class Ⅰ-Ⅱ.Systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）,respiratory rate（RR）,SpO2,VAS scale and Ramsay scale were recorded in eight different points in time,including the time of arriving at the operating room and doing the venipuncture as base line（T0）,the end of infusion of the loading dose of DEX intravenously（T1）,the time of finishing the local anesthesia（T2）,the time of incising skin（T3）,the time of doing the lymphaticovenous anastomosis（T4）,the time of stopping the infusion of DEX（T5）,the time of suturing skin（T6）and the end of the surgery（T7）.Both the degree of satisfaction of the surgeons and the patients,and the memory during the surgery of the patients were evaluated.Results Comparing to the base line（T0）,the SBP,DBP and HR decreased（P〈0.05）during the procedure（T1-6）and then return to base line at the end of the procedure（P〈0.05）,the Ramsay score elevated significantly（P〉0.05）during the procedure（T1-6）and still elevated slightly（P〉0.05）at the end of the procedure.Most surgeons and patients were satisfied with this anesthesia technique.Conclusion DEX combined with dezocine in lymphaticovenous anastomosis with local anesthesia,is efficacy and safety because of better sedation score,surgeons and patients＇ satisfaction and the stable patients＇ vital sign,it showed great function of sedation,amnesia,anesthesia and maintaining the hemodynamic stability.

关 键 词：淋巴静脉吻合术 右美托咪定 局部麻醉 

分 类 号：R614.3[医药卫生—麻醉学]