右美托咪啶用于高血压患者镇痛镇静的临床观察

目的观察右美托咪啶用于高血压患者臂丛阻滞麻醉下镇痛镇静的效果和安全性。方法选择46例臂丛阻滞麻醉下高血压患者,随机分为M组（输注右美托咪啶0.5μg/（kg.h）,S组（输注等速度的生理盐水）,n=23。记录术中血流动力学变化,脉搏氧饱和度（SpO2）、血浆皮质醇浓度、改良清醒镇静评分（OAA/S）、视觉模拟评分（VAS）和患者合作度评分,同时观察术中嗜睡和躁动等不良反应。结果两组患者术中血流动力学比较有统计学意义（P〈0.05）;M组患者的合作度评分高于S组（P〈0.05）;两组患者术中VAS有统计学意义（P〈0.05）;两组患者血浆皮质醇浓度有统计学意义（P〈0.05）。结论右美托咪啶用于臂丛阻滞麻醉下高血压患者,抑制围术期应激反应,缓解患者紧张焦虑,提高患者术中镇痛的满意度,安全有效。

Evaluation of dexmedetomidine for sedation and analgesia in hypertension patient

OBJECTIVE To evaluate the efficacy and safety of dexmedetomidine for sedation and analgesia in hypertension patients undergo brachiplex nerve block.METHODS Forty-six ASA classⅠor Ⅱpatients were divided equally and randomly into two groups.the patients in Group M received dexmedetomidine 0.5μg/(kg·h),and those in Group S received 0.9% Nacl solution 0.1μg/(kg·h).n=23.Hemodynamic changes,pulse oxygen saturation(SpO2),concentration of plasma cortisol,OAA/S,VRS and cooperation score were record during surgery,The incidence rate of adverse events were recorded at the same time.RESULTS Patients in the two groups show significant difference in the hemodynamic changes(P<0.05).Compared with group S,the concentration of plasma cortisol was significantly decreased in group M in surgery(P<0.05).the cooperation score in group M was increased compared with group S(P<0.05).The VAS in two groups show significant difference in surgery(P<0.05).CONCLUSION Dexmedetomidine is safe and effective for sedation and analgesia in hypertension patients undergo brachiplex nerve block,eases the anxiety,improves the satisfaction of patient and can effectively inhibit the stress reaction in perioperative periods.