摘要
目的：探讨静脉预注右美托咪定对罗哌卡因蛛网膜下腔阻滞麻醉效应及生命体征的影响。方法：选择符合标准的患者89例,随机分为观察组45例和对照组44例,观察组在麻醉前应用右美托咪定,对照组给予等体积的0.9%氯化钠注射液,观察记录入室（T0）、开始预注后10min（T1）、麻醉穿刺时（T2）、开始预注后30min（T3）、60min（T4）及术后即刻（T5）、术后10min（T6）、30min（T7）Ramsay镇静评分、平均动脉压（MAP）及心率（HR）,以及麻醉效果。结果：两组患者T0时Ramsay镇静评分相似,差异无统计学意义（P〉0.05）,T1-T7时间点观察组高于本组T0时间点,并且高于对照组相应时间点评分,差异有统计学意义（P〈0.05）。两组患者最高感觉阻滞平面及运动阻滞达到Bromage 3分时间相似,差异无统计学意义（P〉0.05）;但是观察组最高感觉阻滞平面消退至S1的时间及运动阻滞恢复至Bromage 0分的时间长于对照组,差异有统计学意义（P〈0.05）。两组患者T0时间点MAP及HR相似,差异无统计学意义（P〉0.05）;两组患者T1-T5时间点MAP、HR与本组T0时比较,差异有统计学意义（P〈0.05）;两组相应时间点MAP相似,差异无统计学意义（P〉0.05）;观察组HR低于对照组相应时间点,差异有统计学意义（P〈0.05）。结论：静脉预注右美托咪定可以延长罗哌卡因蛛网膜下腔阻滞感觉及运动阻滞时间,对血压无明显影响,能较好的维持循环稳定。
Objective： To investigate the effect of intravenously pre- injected dexmedetomidine on the vital signs and anaesthetic effects in patients under ropivacaine subarachnoid block anesthesia. Method： A total of 89 eligible patients were selected and randomly divided into observation group（ 45 patients） and control group（ 44 patients）. The observation group used dexmedetomidine before anesthesia,while the control group used an equivalent volume of 0.9% sodium chloride injection,and the anaesthetic effects and Ramsay sedation scores,mean arterial pressures（ MAP）,and heart rates（ HR） when entering operation rooms（ T0）,at 10 min after pre-injection（ T1）,when puncture for anesthesia（ T2）,at 30 min after pre-injection（ T3）,at 60 min after pre-injection（ T4）,at the end of surgeries（ T5）,at 10 min after the surgeries（ T6）,and at 30 min after the surgeries（ T7） were observed and recorded. Result： The patients of the two groups had similar Ramsay sedation scores at T0,and the difference was statistically insignificant（ P〉0.05）; at T1- T7,the patients of the observation group had higher Ramsay sedation scores than those of the observation group at T0,and higher than those at the corresponding time points of the control group,and the differences were statistically significant（ P〈0.05）. The patients of the two groups had similar maximum sensory block levels and times of motor block to Bromage 3,and the differences were statistically insignificant（ P〉0.05）;but the observation group had longer times to achieve sensory block regression to the S1 and to achieve motor block recovery to Bromage 0 than the control group,and the differences were statistically significant（ P〉0.05）. The patients of the two groups had similar MAP and HR at T0,and the differences were statistically insignificant（ P〉0.05）; The patients of the two groups had similar MAP at T1- T7,and the differences were statistically insignificant（ P〈0. 05）; the patients of the observation group had lower HR than the control group at T1- T7,and the differences were statistically significant（ P0.05）. Conclusion： Intravenously pre-injected dexmedetomidine can prolong the durations of motor and sensatory blocks of ropivacaine subarachnoid block anesthesia,has insignificant effect on blood pressure,and consequently can maintain the stabilization of the circulatory system.
出处
《河北医学》
CAS
2015年第8期1384-1387,共4页
Hebei Medicine
基金
四川省卫生科研课题
(编号:120414)
