|
| 不同剂量右美托咪定滴鼻用于后路腰椎管减压内固定术患者术前镇静效果的比较 |
| Comparison of intranasal premedication with different doses of dexmedetomidine on the preoperative sedation in patients undergoing posterior lumbar decompression and internal fixation surgery |
| |
| DOI：10.12089/jca.2020.01.007 |
| 中文关键词: 右美托咪定 滴鼻 后路腰椎管减压内固定术 术前用药 |
| 英文关键词: Dexmedetomidine Intranasal administration Posterior lumbar decompression and internal fixation surgery Premedication |
| 基金项目:江苏省“六大人才高峰”资助项目(2015-WSN-012) |
|
| 摘要点击次数: 3305 |
| 全文下载次数: 997 |
| 中文摘要: |
目的 探讨经鼻给予不同剂量右美托咪定用于后路腰椎管减压内固定术患者术前镇静的效果。
方法 选择择期后路单间隙腰椎管减压内固定术患者80例,男46例,女34例,年龄18～65岁,BMI 18～25 kg/m2,ASA Ⅱ或Ⅲ级。随机分为右美托咪定1.0 μg/kg组(D1.0组)、右美托咪定1.5 μg/kg组(D1.5组)、右美托咪定2.0 μg/kg组(D2.0组)和对照组(C组)。患者入手术室后,D1.0组、D1.5组、D2.0组分别经鼻滴注右美托咪定1.0、1.5、2.0 μg/kg,C组用生理盐水滴鼻，容量均为2 ml。记录滴鼻前(T0) 、滴鼻后10 min(T1)、20 min(T2)和30 min(T3)的HR、MAP、SpO2、自发痛VAS评分、Ramsay镇静和焦虑评分。滴鼻后30 min行左侧上肢肘正中静脉穿刺和桡动脉穿刺置管,记录患者穿刺时VAS评分和满意度评分,并抽取桡动脉血行血气分析。
结果 T3时 D2.0组HR明显慢于C组(P<0.05),MAP明显低于C组(P<0.05)。T3时D1.0、D1.5和D2.0组自发痛VAS评分明显低于C组(P<0.05),Ramsay镇静评分明显高于C组(P<0.05),T3时D1.0和D1.5，T2、T3时D2.0组焦虑评分明显低于C组(P<0.05)。 D1.5组和D2.0组静脉穿刺和桡动脉穿刺VAS评分明显低于C组(P<0.05),D1.0、D1.5和D2.0组满意度明显高于C组(P<0.05)。
结论 后路腰椎管减压内固定术患者术前给予右美托咪定1.5 μg/kg滴鼻可获得良好的镇静效果,提高患者的满意度。 |
| 英文摘要: |
Objective To investigate the effects of various doses of intranasal dexmedetomidine premedication on the preoperative sedation in patients undergoing posterior lumbar decompression and internal fixation surgery.
Methods Eighty patients, 46 males and 34 females, aged 18-65 years, falling into ASA physical status Ⅱ or Ⅲ category who were scheduled for elective posterior lumbar decompression and internal fixation surgery were randomly allocated into four groups. Groups D1.0, D1.5 and D2.0 were given intranasal 1.0, 1.5 and 2.0 μg/kg of dexmedetomidine respectively, while group C was given intranasal normal saline. HR, MAP, SpO2, VAS of spontaneous pain and the scores of anxiety and sedation were recorded before intranasal administration (T0), 10 min (T1), 20 min (T2) and 30 min (T3) after administration. Thirty minutes after administration, the median cubital vein and radial artery of the left upper extremity were catheterized. The VAS of puncture pain and the degree of satisfaction were assessed and the arterial blood gas analysis was carried out.
Results Compared with group C, HR and MAP at T3 in group D2.0 were reduced significantly (P<0.05). Compared with group C, the VAS of spontaneous pain at T3 in groups D1.0, D1.5 and D2.0 were decreased significantly and the Ramsay sedation scale at T3 in groups D1.0, D1.5 and D2.0 were increased significantly (P<0.05). Compared with group C, the anxiety scale at T3 in groups D1.0 and D1.5 and at T2 and T3 in group D2.0 were reduced significantly (P<0.05). VAS of venous and arterial puncture pain were decreased significantly in groups D2 and D3 compared with group C (P<0.05). The satisfactory degree was increased significantly in groups D1.0, D1.5 and D2.0 compared with group C (P<0.05).
Conclusion Intranasal premedication with dexmedetomidine 1.5 μg/kg in patients undergoing posterior lumbar decompression and internal fixation surgery could achieve favorable sedation level, improve the satisfactory degree. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
