盐酸右美托咪定应用于连续硬膜外麻醉经皮钬激光碎石术的临床研究

目的探讨盐酸右美托眯定在连续硬膜外麻醉下经皮肾镜钬激光碎石术的辅助镇静应用。方法将经皮肾镜肾结石Ⅰ-Ⅱ期钬激光碎石术的100例患者，按随机数字表法分为2组：连续硬膜外麻醉辅助应用盐酸右美托咪定（D组），单纯连续硬膜外麻醉联用等容量生理盐水（C组），各50例。观察记录2组手术过程中给药前（TB），10min负荷量后即刻（TO），负荷量后5（T5）、10（T10）、15（T15）、20（T20）、25（T25）、30（T30）、45（T45）、60（T60）、90（T90）min的HR、SpO2及RR、MAP、OAA／S评分变化。结果OAA／S镇静评分示D组较C组具有显著的镇静效果（P〈0．05），D组HR值T15-T60时段显著慢于TB时及C组同时段（P〈0．05），2组Sp02、RR及MAP相比差异无统计学意义（P〉0．05）。结论盐酸右美托咪定辅助应用于连续硬膜外麻醉下钬激光碎石术中的镇静效果优越，是一种安全有效的镇静药物。

Dexmedetomidine as an Adjunct to Epidural Analgesia in Percutaneous Nephrolithotripsy with Holmium Laser

Objective To evaluate the application of dexmedetomidine as an adjunct to continuous epidural anesthesia in percutaneous nephrolithotripsy with holmium laser. Methods One hundred kidney stone patients （stage Ⅰ-Ⅱ ）undergoing percutaneous nephrolithotripsy with holmium laser were randomly assigned to receive isovolume epidural administration of either dexmedetomidine hydro- chloride（group D） or normal saline（group C）,with 50 patients in each group. Heart rate（HR）, oxygen saturation （SpO2）, respiratory rate （RR）,mean arterial pressure （MAP）and Observer＇s Assessment of Alertness/Sedation （OAA/S） scores were measured before administration （TB）, after 10 minutes of loading （TO）, and at 5（T5）, 10（T10）, 15（T15）, 25（T25）, 30（T30）, 45（T45）, 60（T60） and 90（T90） minutes after loading. Results Compared with group C, dexmedetomidine hydrochloride significantly increased OAA/ S scores, and obviously decreased HR during T15-T60（P〈0.05）. While there were no significant differences between the two groups in SpO2, RR and MAP（P〉0.05）.Conclusion Dexmedetomidine hydroch- loride,as an adjunct to epidural anesthesia,is safe and effective in percutaneous nephrolithotripsy with holmium laser.