右美托咪定用于老年阿尔茨海默病患者术后镇痛效果观察  

Observation on Postoperative Analgesic Effect of Dexmedetomidine on Elderly Patients with Alzheimer’s Disease

作　　者：李帛谦 王小锐[1] 董玥颖 沈海琳 LI Boqian;WANG Xiaorui;DONG Yueying;SHEN Hailin(Dept.of Anesthesia,the Second Hospital of Tangshan,Hebei Tangshan 063000,China)

机构地区：[1]唐山市第二医院麻醉科

出　　处：《中国医院用药评价与分析》2019年第6期688-690,共3页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省卫生厅科研基金项目(No.20150929)

摘　　要：目的:探讨右美托咪定用于老年阿尔茨海默病患者术后镇痛的效果。方法:选取2015年6月至2018年5月唐山市第二医院收治的拟行上肢骨折手术的老年阿尔茨海默病患者100例,按照随机数字表法分为观察组和对照组,每组50例。两组患者均采用腋路臂丛神经阻滞麻醉,对照组患者术后给予罗哌卡因,观察组患者术后在对照组的基础上加用右美托咪定。观察两组患者的麻醉前(T0)、术后麻醉1h(T1)及术后6h(T2)的镇静情况,术后镇痛效果、术后血流动力学指标水平及麻醉效果。结果:T1时,观察组患者的警觉/镇静评分明显低于对照组;T2时,观察组患者的警觉/镇静评分明显高于对照组;术后,观察组患者的视觉模拟评分明显低于对照组,上述差异均有统计学意义(P<0.05)。给药6、12及24h后,观察组患者的心率明显高于对照组,血氧饱和度水平明显低于对照组;给药12、24h后,观察组患者的平均动脉压水平明显低于对照组,差异均有统计学意义(P<0.05)。观察组患者的感觉阻滞时间明显短于对照组,而感觉阻滞持续时间、镇痛持续时间明显长于对照组,差异均有统计学意义(P<0.05)。结论:右美托咪定用于老年阿尔茨海默病患者术后镇痛效果显著。OBJECTIVE: To probe into the postoperative analgesic effect of dexmedetomidine on elderly patients with Alzheimer’s disease. METHODS: 100 elderly patients with Alzheimer’s disease undergoing upper limb fracture surgery admitted into the Second Hospital of Tangshan from Jun. 2015 to May 2018 were selected and divided into observation group and control group via the random number table, with 50 cases in each group. Both groups were given axillary brachial plexus block anesthesia, the control group was given ropivacaine after surgery, while the observation group was given dexmedetomidine after surgery. Sedation before anesthesia(T0), 1 h after anesthesia(T1) and 6 h after surgery(T2) were observed. And postoperative analgesia effect, postoperative hemodynamic indices and anesthetic effects of the two groups were observed. RESULTS: At T1, the observers assessment of alertness/sedation scale(OAA/S) of observation group was significantly lower than that of the control group;at T2, the OAA/S of observation group was significantly higher than that of the control group;after surgery, score of visual analogue scale of observation group was significantly lower than that of the control group, with statistically significant differences(P<0.05). At 6 h, 12 h and 24 h after administration, the heart rates of observation group were significantly higher than those of the control group, the oxyhemoglobin saturation levels of observation group were significantly lower than those of the control group;at 12 h and 24 h after administration, the mean arterial pressure levels of observation group were significantly lower than those of the control group, with statistically significant differences(P<0.05). The sensory block time of observation group was significantly shorter than that of the control group, while the duration of sensory block and analgesia of observation group were significantly longer than the control group, with statistically significant differences(P<0.05). CONCLUSIONS: The analgesic effect of dexmedetomidine in pos

关 键 词：阿尔茨海默病 老年患者 臂丛神经阻滞麻醉 手术 右美托咪定 

分 类 号：R971.2[医药卫生—药品]