|
| 右美托咪定对老年患者骨科手术后睡眠质量的影响 |
| Effect of dexmedetomidine on postoperative sleep quality in elderly orthopaedic patients |
| |
| DOI：10.12089/jca.2018.07.016 |
| 中文关键词: 右美托咪定 尿6-羟基硫酸褪黑素 睡眠质量指数 |
| 英文关键词: Dexmedetomidine aMT6s Sleep quality index |
| 基金项目: |
|
| 摘要点击次数: 3270 |
| 全文下载次数: 1083 |
| 中文摘要: |
目的 探讨右美托咪定改善老年骨科患者手术后睡眠质量。
方法 选择2016年5月至2017年12月骨科老年手术患者120例,男66例,女54例,年龄75～93岁,BMI 18.5～23.9 kg/m2,ASA Ⅱ 或 Ⅲ 级。随机分为两组:右美托咪定组(D组)和对照组(C组),每组60例。所有患者气管插管全麻下行手术治疗,缝皮时停止使用麻醉药物,静注托烷司琼5 mg后接静脉自控镇痛(PCIA)并开启术后镇痛,D 组镇痛药物为舒芬太尼1.5～2.5 μg/kg+托烷司琼5 mg+右美托咪定2 μg/kg。C 组镇痛药物为舒芬太尼1.5～2.5 μg/kg+托烷司琼5 mg,泵注速度1.0～2.5 ml/h,单次追加量为 0.5 ml,锁定时间15 min,总容量100 ml。术后疼痛视觉模拟评分(VAS评分)>3分时患者行自控镇痛或非甾体抗炎药物辅助。自主呼吸恢复后拔管前给予静注氟马西尼0.3～0.5 mg、新斯的明0.5～1 mg、阿托品0.2～0.5 mg。于术前1天(T0)、术后第1天(T1)、术后第2天(T2)、术后第3天(T3)和术后第4天(T4)分别收集患者晨起第一次尿液2 ml,检测并记录6-羟基硫酸褪黑素(aMT6s)浓度。于术前、术后24 、48 h和出院前进行匹兹堡睡眠质量指数(PSQI)评分,记录术后4 、8、12、24和48 h的VAS评分。
结果 D组T1-T4时aMT6s明显高于C组(P<0.05)。D组术后24、48 h和出院前PSQI评分明显低于C组(P<0.05)。两组不同时点VAS评分差异无统计学意义。
结论 右美托咪定对老年患者骨科手术后睡眠质量有明显的改善。 |
| 英文摘要: |
Objective To study the efficacy of dexmedetomidine on the postoperative sleep quality in elderly orthopaedic patients.
Methods One hundred and twenty elderly patients in orthopaedic, 66 male, 54 female, aged 75 to 93, with BMI 18.5 to 23.9 kg/m2, ASA physical stutes grade Ⅱ or Ⅲ, were chosen from May 2016 to December 2017, randomized divided into two groups, control group (group C) dexmedetomidine group (group D) and control group (group C), 60 cases in each. All patients were treated with tracheal intubation under general anesthesia. When the incision was closed, all patients turned on controlled intravenous analgesia (PCIA). Group D was including sufentanil 1.5-2.5 μg/kg+tropisetron 5 mg+dexmedetomidine 2 μg/kg, group C sufentanil 1.5-2.5 μg/kg+tropisetron 5 mg. Background infusion rate was 2 ml/h, bolus 0.5 ml and lockout time 15 min, total capacity 100 ml. When VAS> 3, patients were assisted with self-controlled analgesia or non-steroidal anti-inflammatory drugs. When the voluntary respiration restored, flumazenil 0.3-0.5 mg, neostigmine 0.5-1 mg atropine 0.2-0.5 mg were injected before extubation. 2 ml urine was collected at first urine in the morning before surgery (T0), first urine in the morning on the first day to the forth day after surgery (T1-T4), The concentration of 6-hydroxyl sulphate melatonin (aMT6s) was detected and recorded. PSQI was assessed preoperative, 24 hours postoperative, 48 hours postoperative, and before discharging from hospital. VAS score was observed 4, 8, 12, 24 and 48h after surgery.
Results In group D, aMT6s were significantly higher than that in group C from T1 to T4(P<0.05). In group D, PSQI were significantly lower than that in group C(P<0.05).There was no significant difference in VAS scores between the two groups at different time points.
Conclusion Dexmedetomidine could improve the postoperative sleep quality significantly in elderly orthopaedic patients. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
