右美托咪定鼻腔、静脉给药的镇静效果比较  

Comparison of sedative effects of intranasal and intravenous administration of dexmedetomidine

作　　者：张大鹏[1] 毛祖旻 陈正[1] ZHANG Da-peng;MAO Zu-min;CHEN Zheng(Anesthesiology Department,the People's Hospital Affiliated to Jiangsu University,Zhenjiang 212000,China)

机构地区：[1]江苏大学附属人民医院麻醉科

出　　处：《临床医学研究与实践》2019年第15期39-41,共3页Clinical Research and Practice

摘　　要：目的比较右美托咪定鼻腔、静脉给药的镇静效果。方法将拟在本院行臂丛麻醉下上肢手术的60例患者用随机数字表法分为静脉泵注组(n=20,静注1.0μg/kg右美托咪定)、鼻喷1组(n=20,鼻喷1.0μg/kg右美托咪定)和鼻喷2组(n=20,鼻喷2.0μg/kg右美托咪定)。患者均于超声引导下行臂丛神经阻滞,手术开始前均给予右美托咪定镇静。比较三组的镇静效果。结果三组有效镇静患者占比无显著差异(P>0.05);且三组均未出现过度镇静患者。鼻喷1组镇静起效时间长于静脉泵注组和鼻喷2组,镇静维持时间短于静脉泵注组和鼻喷2组(P<0.05)。鼻喷2组镇静起效时间长于静脉泵注组(P<0.05),但两组间镇静维持时间无显著差异(P>0.05)。鼻喷1组时间-OAA/SAUEC及时间-BISAUEC大于静脉泵注组和鼻喷2组(P<0.05);而静脉泵注组和鼻喷2组间无显著差异(P>0.05)。三组低血压发生率无显著差异(P>0.05)。静脉泵注组、鼻喷2组心动过缓发生率高于鼻喷1组(P<0.05),但静脉泵注组、鼻喷2组间无显著差异(P>0.05)。结论鼻喷右美托咪定较静注同等剂量所产生的镇静效果更弱,且镇静起效慢;将鼻喷剂量提高至2.0μg/kg,能够取得良好的镇静效果。Objective To compare the sedative effects of intranasal and intravenous administration of dexmedetomidine.Methods Sixty patients undergoing lower and upper limb surgery under brachial plexus anesthesia in our hospital were divided into intravenous pump group (n=20, intravenous administration of 1.0 μg/kg dexmedetomidine), intranasal administration group 1 (n=20, intranasal administration of 1.0 μg/kg dexmedetomidine) and intranasal administration group 2 (n=20, intranasal administration of 2.0 μg/kg dexmedetomidine).All patients received ultrasound-guided brachial plexus block and dexmedetomidine for sedation before operation.The sedative effects of the three groups were compared.Results There were no significant differences in the proportion of patients with effective sedation among the three groups (P>0.05), and no patients with excessive sedation in the three groups.The sedation onset time of the intranasal administration group 1 was longer than that of the intravenous pump group and the intranasal administration group 2, the sedation maintenance time was shorter than that of the intravenous pump group and the intranasal administration group 2 (P<0.05).The sedation onset time of the intranasal administration group 2 was longer than that of the intravenous pump group (P<0.05), but there was no significant difference in sedation maintenance time between the two groups (P>0.05).The AUECs of time-OAA/S and time-BIS in the intranasal administration group 1 were significantly higher than those of the intravenous pump group and the intranasal administration group 2 (P<0.05), but there were no significant differences between the intravenous pump group and the intranasal administration group 2 (P>0.05).There was no significant difference in the incidence of hypotension among the three groups (P>0.05).The incidence of bradycardia in the intravenous pump group and the intranasal administration group 2 was higher than that in the intranasal administration group 1 (P<0.05), but there was no significant difference betwee

关 键 词：右美托咪定 鼻腔给药 静脉给药 镇静 

分 类 号：R614[医药卫生—麻醉学]