右美托咪定辅助腰硬联合麻醉在膝关节镜手术中的镇静作用

发布时间：2018-11-21 18:07

【摘要】：目的探讨右美托咪定辅助腰硬联合麻醉下老年患者膝关节镜手术中镇静的有效性和安全性。方法 50例腰硬联合麻醉下行膝关节镜手术的老年患者,随机分为右美托咪定组(D组)和空白组(K组),每组25例。记录麻醉前(T0)、手术中30 min(T1)及麻醉结束拔管后5 min(T2)各时间点的脑电双频指数(BIS)、心率(HR)、呼吸次数(RR)、血氧饱和度(Sp O2)及平均动脉压(MAP),观察48 h内不良反应的发生情况及术后24 h遗忘程度,对右美托咪定在术中镇静效果进行观察和评估。结果 D组患者中T1和T2时间点的BIS值显著低于K组,T1时间点的HR低于K组,遗忘程度显著高于K组(均P0.05),两组MAP、RR、Sp O2、不良反应情况比较差异无统计学意义(P0.05)。结论右美托咪定辅助腰硬联合麻醉下老年患者膝关节镜手术的镇静是有效和安全的,呼吸循环稳定,不良反应少,遗忘程度较好。
[Abstract]:Objective to investigate the efficacy and safety of dexmetomidine-assisted combined spinal-epidural anesthesia for sedation in elderly patients undergoing knee arthroscopy. Methods 50 elderly patients undergoing knee arthroscopy under combined spinal-epidural anesthesia were randomly divided into two groups: right metomidine group (group D) and blank group (group K) with 25 cases in each group. Before anesthesia (T0), 30 min (T1) during operation and 5 min (T2) after extubation, the bispectral index (BIS), heart rate (HR), respiration times (RR), were recorded. Blood oxygen saturation (Sp O 2) and mean arterial pressure (MAP),) were used to observe the occurrence of adverse reactions within 48 h and the degree of amnesia 24 h after operation. The sedation effect of dexmetomidine during operation was observed and evaluated. Results in group D, the BIS values at T1 and T2 time points were significantly lower than those in K group, HR at T1 time points were lower than those in K group, and the degree of amnesia was significantly higher than that in K group (P0.05). There was no significant difference in adverse reactions (P0.05). Conclusion the sedation of knee arthroscopy in elderly patients under combined spinal-epidural anesthesia with dexmetidine is effective and safe, with stable respiration and circulation, less adverse reactions and good degree of amnesia.
【作者单位】：北京市第二医院麻醉科;
【分类号】：R614

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