右美托咪定在肥胖患者锁骨骨折内固定术中的应用

目的：观察右美托咪定在肥胖患者锁骨骨折内固定术中的镇痛镇静效果及不良反应。方法：60例择期行锁骨骨折内固定术肥胖患者用数字表法随机分为2组：右美托咪定组（D组）和咪达唑仑组（M组）各30例。记录2组术中生命体征、Ramsay 镇静评分、芬太尼总用量及不良反应发生情况。结果：术中D组血压低于M组，心率慢于M组，差异有统计学意义（P<0.05），D组芬太尼总用量少于M组，差异有统计学意义（P< 0.05）；D 组Ramsay 镇静评分高于M组，差异有统计学意义（P<0.05）；D 组呼吸抑制、恶心呕吐发生率低于M组，差异有统计学意义（P<0.05）。结论：右美托咪定用于锁骨骨折内固定术肥胖患者具有血流动力学较平稳，镇痛、镇静效果确切，芬太尼总用量减少，呼吸抑制、恶心呕吐发生率低等优点，值得临床推广应用。

Application of dexmedetomidine in obese patients with clavicle fracture fixation operation

OBJECTIVE To observe analgesic efficacy and adverse drug reactions of dexmedetomidine for obese patients with clavicle fracture fixation operation. METHODS Sixty obese patients with clavicle fracture fixation operation were randomly divided into two groups: one group received intravenous injection of dexmedetomidine (group D, n=30); another group received intravenous injection of midazolam(group M, n=30);The vital signs, Ramsay sedation scores, fentanyl dosage and adverse reactions were recorded for the two groups. RESULTS Blood pressure were lower and heart rate were slower in group D than in group M(P<0.05); fentanyl dosage of group D were less than group M (P<0.05); Ramsay sedation scores were higher in group D than in group M (P<0.05).Incidence of respiratory depression, nausea and vomiting were lower in group D than in group M (P<0.05). CONCLUSION For obese patients with clavicle fracture fixation operation, dexmedetomidine can maintain the stability of hemodynamics and obtain better sedative and analgesia effects with the advantages of less fentanyl dosage and lower incidence of respiratory depression, nausea and vomiting, which is worth of popularizing..