右美托咪定在硬膜外麻醉下输尿管镜钬激光碎石术中的镇静效果观察

目的观察右美托咪定(DEX)用于输尿管镜钬激光碎石术(URHL)的镇静效果。方法将312例行URHL的输尿管结石患者随机分为A组、B组,每组156例。术中A组与B组分别静脉泵注DEX、丙泊酚维持麻醉。记录麻醉前(T0)、置入输尿管镜(T1)、碎石时(T2)、灌洗时(T3)、术毕(T4)时的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)及警觉/镇静(OAA/S)评分。结果 T2^T4时,A组HR、MAP低于B组(P<0.05);T2T4时,A组HR、MAP低于B组(P<0.05);T2^T4时,A组SpO2高于B组(P<0.05);T2T4时,A组SpO2高于B组(P<0.05);T2^T3时,A组OAA/S低于B组(P<0.05);T4时,两组OAA/S评分比较差异无统计学意义(P>0.05)。A组不良反应发生率低于B组(P<0.05)。结论 DEX用于URHL持续硬膜外麻醉,镇静效果好,血流动力学稳定,不良反应少。

Observation of sedative effects of dexmedetomidine in the epidural anesthesia for ureteroscope holmium laser lithotripsy

Objective To observe the sedative effects of DEX for ureteroscope holmium laser lithotripsy （URHL）. Methods 312 patients with ureterai calculi which underwent URHL were randomly divided into two groups,patients in group A and group B were given intraoperative intravenous infusion of propofol and DEX maintain anesthesia respectively. The HR,MAP,SpO2 and OAA/S score were recorded before anesthesia（T0）, at the time of placed ureteroscopy（T1） ,gravel（T2） ,lavage（T3） and surgery（T4）. Results The HR,MAP during T2 -T4 of group A were lower than those of group B （ P 〈 0. 05 ） ; the SpO2 during T2 - T4 of group A was higher than that of group B （ P 〈 0. 05 ） ; OAA/S during T2 - T3 of group A was lower than that of group B （ P 〈 0. 05 ）, but no significant difference was found in OAA/S score at T4 between the two groups（ P 〉 0.05 ）. The incidence of adverse reactions of group A was lower than that of group B （ P 〈 0. 05 ）. Conclusion DEX in the URHL continuous epidural anesthesia has good sedation effect and stable hemodynamic, with fewer adverse reactions.