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| 羟考酮联合右美托咪定在老年患者下肢动脉闭塞支架置入手术中的应用 |
| Application of oxycodone combined with dexmedetomidine in elderly patients undergoing surgeries of artriosclerosis obliterans |
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| DOI：10.12089/jca.2020.01.012 |
| 中文关键词: 羟考酮 右美托咪定 芬太尼 下肢动脉硬化闭塞症 监测麻醉 |
| 英文关键词: Oxycodone Dexmedetomidine Fentanyl Artriosclerosis obliterans Monitored anesthesia care |
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| 中文摘要: |
目的 探讨羟考酮联合右美托咪定在老年患者下肢动脉闭塞(artriosclerosis obliterans, ASO)手术监测麻醉(monitored anesthesia care, MAC)的临床效果及安全性。
方法 选择2017年6月至2018年12月择期行下肢动脉闭塞介入手术治疗患者80例,男63，女17，年龄65~85岁，ASA Ⅱ或Ⅲ级,采用随机数字表法分为羟考酮联合右美托咪定组(O组,n=40)和芬太尼联合右美托咪定组(F组,n=40)。记录有创测压后患者平静呼吸5 min后(T1)、股动脉穿刺置鞘时(T2)、球囊扩张时(T3)、手术结束时(T4)的MAP、HR以及SpO2;术中VAS、Ramsay评分、手术时间、出室时Ramsay评分。同时观察围术期不良反应。
结果 两组患者一般情况、下肢动脉硬化闭塞分级、手术时间和出室Ramsay评分差异均无统计学意义。与T1时比较,T2时两组MAP明显降低,HR明显减慢，且F组明显低于O组(P<0.05)。T3时F组VAS评分、Ramsay评分明显高于O组，术毕至出恢复室观察时间明显长于O组(P<0.05)。术中体动反应、术中呼吸抑制以及术后恶心呕吐发生率F组明显高于O组(P<0.05)。
结论 羟考酮联合右美托咪定可安全用于老年患者下肢动脉闭塞手术监测麻醉中,能够有效控制疼痛反应,提高手术舒适度,维持术中循环稳定,减少术中呼吸抑制发生率以及术后恶心呕吐发生率。 |
| 英文摘要: |
Objective To explore the effect and safety of monitored anesthesia care (MAC) for oxycodone combined with dexmedetomidine in elderly patients undergoing surgeries of artriosclerosis obliterans (ASO).
Methods Eighty patients, 63 males and 17 females, aged 65-85 yr, falling into ASA Ⅱ or Ⅲ category, who underwent surgeries of artriosclerosis obliterans in our hospital from Jun 2017 to Dec 2018 were randomly divided into oxycodone group (group O) and fentanyl group (group F), 40 patients in each group The MAP, HR, SpO2 at each time point, VAS, Ramsay score, surgery time and occurrence rate of adverse reactions were recorded in the two groups.
Results There was no significant difference in general condition, atherosclerosis condition,surgery time and Ramsay score of leaving recovery room betwwen the two groups. There was no significant difference in MAP, HR and SpO2 at T1 betwwen the two groups. Both MAP and HR were decreased in the two groups at T2, MAP and HR were lower in group F (P<0.05).Compared with group O,the VAS score, Ramsay score at T3, recovery time were higher in group F (P<0.05). The occurrence rate of adverse reactions such as body movement, respiratory depression and postoprative nausea and vomiting was higher in group F (P<0.05).
Conclusion The MAC strategy of oxycodone combining with dexmedetomidine can be safely used in elderly patients undergoing surgeries of artriosclerosis obliterans, which can control pain response, improve surgical comfort, maintain intraoperative circulatory stability, reduce the incidence of intraoperative respiratory depression and postoperative nausea and vomiting. |
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