右旋美托咪啶对硬膜外麻醉患者镇静效应的影响

目的:观察右旋美托咪啶(Dex)对硬膜外患者的镇静效应及其对呼吸循环的影响,探讨其能否安全有效地应用于硬膜外麻醉患者。方法:选择60例下肢手术患者,行硬膜外麻醉,麻醉平面测试满意后,用微量泵泵注右旋美托咪啶,负荷量0.4μg/kg,10min内泵完,然后以0.2μg/(kg.h)维持输注,记录给药前(T0)、输注负荷量结束即刻(T1)、输注维持量5min(T2),输注维持量10min(T3)、输注维持量30min(T4)、输注维持量1h(T5),停止输注后10min(T6)、停止输注后30min(T7)时的脑电双频谱指数(BIS)、SBP、DBP、MAP、HR、RR、SpO2,并对患者进行OAA/S镇静评分。结果:T1-T7时点患者的SBP、DBP、MAP、SpO2与T0时相比差异无统计学意义,但在T1～T7时点患者的HR明显降低,与T0时相比差异有统计学意义(P<0.05),同时RR在T1～T6时也明显降低,差异亦有统计学意义(P<0.05);T1～T5时点的BIS值与T0时BIS值相比明显降低差异亦有统计学意义(P<0.05);在T1～T6时OAA/S评分明显降低,与T0时的值相比差异亦有统计学意义(P<0.05);但在T7时,BIS、OAA/S评分与T0时相比差异无统计学意义(P>0.05)。结论:右旋美托咪啶可安全有效地应用于硬膜外麻醉患者的术中镇静。

The Sedative Effect of Dexmedetomidine on the Patient Undergoing Epidural Anesthesia

Objective:To evaluate the efficacy and security of dexmedetomidine in patients undergoing epidural anesthesia.Methods:60 patients whose lower limb would be operated were given Dex 0.4μg/kg in 10min as bolus,then were given Dex 0.2μg/(kg.h) by contiuous pump after satisfied epidural anesthesia.BIS,SBP,DBP,MAP,HR,RR and SpO 2 were recorded at T0(before given Dex),T1(the finished moment after given 0.4μg/kg);and T2(5min),T3(10min),T4(30min),T5(1h) during the matainance;T6(10min) and T7(30min) after stop drug.Patients’ sadative degree scores(OAA/S) were evaluated.Results:Compared with T0,SBP,DBP,MAP,SpO 2 at T1～T7 had no significant significance(P>0.05),while HR reduced apparently(P<0.05).RR,OAA/S at T1～T6,BIS of patients at T1～T5 were lower than those at T0 P<0.05).Conclusions:Dexmedetomidine is safe and effective for patient’s sedation during epidural anesthesia.