右美托咪定联合咽喉部表面麻醉在老年患者左心耳封堵术中的研究

目的 观察右美托咪定联合咽喉部表面麻醉在老年患者经皮左心耳封堵术中的安全性和舒适度。方法 选择拟行左心耳封堵术患者28例，随机均分为两组，即对照组（S组，n=14）和右美托咪定组（M组，n=14）。S组腹股沟局部浸润麻醉，M组1%盐酸丁卡因咽喉表面麻醉2次，右美托咪定泵注负荷剂量0.5~1.0μg/kg 10min后改为0.3μg/（kg·h）泵注维持，铺巾后腹股沟局部浸润麻醉。记录患者术前、术中及术后生命体征（MAP、HR、SpO₂）的改变，置入食管超声镜期间恶心、呕吐发生率，并对患者进行VAS，Ramsay及BCS评分。结果 S组患者术中HR、MAP、恶心、呕吐发生率高于M组（P<0.05）；两组患者术前VAS，Ramsay及BCS评分差异无统计学意义（P>0.05），S组术中与术后VAS评分高于M组，Ramsay及BCS评分低于M组（P<0.05）。结论 右美托咪定联合咽喉部表面麻醉可以安全用于左心耳封堵术，有效降低患者恶心、呕吐发生率，提高患者舒适度。

Effect of Dexmedetomidine Combined with Surface Anesthesia in Eldly Patients of Percutaneous Closure of Left Atrial Appendage Occlusion

Objective To observe the effect of dexmedetomidine (Dex) combined with surface anesthesia in eldly patients of percutaneous closure of left atrial appendage occlusion. Methods Twenty-eight patients were randomly devided into two groups:group S, group M. Group S were received Local infiltration anesthesia in the groin. Group M were accepted not only surface anesthesia, but also Dex by intravenous and tetracaine for laryngopharynx. We recorded the MAP,HR,SpO₂,the ratio of nausea and vomiting, VAS score, Ramsay score and the BCS score. Results HR, MAP and the ratio of nausea and vomiting in group S were higher than that in group M. The VAS, Ramsay and BCS score in group S compared with group M before operation had no significant difference (P>0.05), however, during and after the operation, the VAS in group S was higher, the Ramsay and BCS score were lower than group M (P<0.05). Conclusion Dex combined with surface anesthesia can be safely used in the percutaneous closure of left atrial appendage occlusion.It can improve the comfortableness of patients.