右美托咪定复合地佐辛用于慢性硬膜下血肿手术患者麻醉的效果

目的观察右美托咪定复合地佐辛用于慢性硬膜下血肿钻孔引流术的麻醉效果及安全性。方法选择行慢性硬膜下血肿钻孔引流术患者60例,随机分为2组：右美托咪定复合地佐辛组（D组）和局部麻醉组（L组）。记录患者入室后（T0）、切皮时（T1）、钻孔时（T2）、缝皮时（T3）、手术结束时（T4）的平均动脉压（Mean arterial pressure,MAP）、心率（Hart rate,HR）、呼吸频率（Rspiratory rate,RR）、呼气末二氧化碳（End-tidal carbon dioxide,ETCO2）和改良警觉/镇静评分（Modified observer＇s assessment of alertness/sedation,MOAA/S）评分;观察术中呼吸抑制和体动反应等不良反应;评价麻醉效果和患者满意度。结果与L组比较,D组T1-4时MAP,HR降低（P〈0.05）,RR和ETCO2两组无差异;D组体动反应例数减少、MOAA/S评分低,心动过缓、低血压的例数多;麻醉效果、患者满意度高（P〈0.05）。结论右美托咪定复合地佐辛应用于慢性硬膜下血肿钻孔引流术,可较好地维持血流动力学平稳,麻醉效果满意,患者能更好的配合手术。

Efficacy of combination of dexmedetomidine and dezocine in trepanation and drainage for chronic subdural hematoma

Objective To observe the effect and safety of combination of dexmedetomidine-dezocine in trepanation and drainage for chronic subdural hematoma.Methods 60 patients undergoing the chronic subdural hematoma were randomly allotted into two groups：combination of dexmedetomidine-dezocine（Group D）and local anesthesia（Group L）.MAP,HR,RR,ETCO2 and MOAA/S were monitored during anesthesia and the monitoring point was as follows：after entering the operating room（T0）、the start of surgery（T1）、the time of drilling（T2）、the time of suturing（T3）、the end of surgery（T4）;changes of respiratory depression and body movements were observed;anesthesia effect scores and satisfaction degree of the patients were evaluated.Results Compared with group L,MAP and HR were decreased at T1-4（P〈0.05）,RR and ETCO2 were no difference;the number of body movements was decreased,MOAA/S score was lower,the number of bradycardia and hypotension was increased;anesthesia effect scores and satisfaction degree of the patients were higher in group D（P〈〈0.05）.Conclusion The combination of dexmedetomidine-dezocine can be used in patients undergoing chronic subdural hematoma safely,and moreover,is able to maintain better stable hemodynamics,have better satisfactory anesthesia effect and let patients better with surgery.