盐酸右美托咪定在硬膜外麻醉下骨科手术中的研究

目的探讨盐酸右美托咪定在骨科手术中的临床应用。方法 90例患者选择硬膜外麻醉的骨科手术,随机分为对照组(C组)、右美托咪定组(D组)和丙泊酚组(P组)。三组患者均接受利罗合剂(1%利多卡因和0.5%罗哌卡因)连续硬膜外麻醉。观察并记录给药前(T0)、切皮前即用药后15 min(T1)、45 min(T2)、术毕(T3)时的心率(HR)、平均动脉压(MAP)、Ramsay镇静评分,并同时测定血糖。结果 C组在T1、T2和T3时间点HR和MAP明显高于D组和P组,Ramsay镇静评分低于D组和P组(P<0.05);D组和P组在T1、T2和T3时MAP明显低于T0(P<0.05),T1时Ramsay镇静评分高于T0(P<0.05);D组在T1、T2和T3时HR明显低于T0。与T0点相比,C组在T1、T2时点血糖升高,且高于D组和P组(P<0.05)。结论盐酸右美托咪定能够对清醒的患者提供良好镇静作用,降低围术期手术患者的血糖,抑制机体的应激反应。

Research of Dexmedetomidine in Orthopedic Surgery

Objective To discuss application of dexmedetomidine during epidural anesthesia in orthopaedic surgery. Methods Ninety patients of selective operation undergoing orthopaedic surgery in epidural anesthesia were randomLy divided into three groups：control group（group C）, dexmedetomidine group （group D） and propofol group （group P）. All patients received low epidural anesthesia with 1%lidocaine and 0.5%ropivacaine hudrochloride. MAP, HR, Ramsay scores, blood sugar were recorded at the time of before administration （T0）, before incision（T1）, 45 min （T2） after operation start, when operation ifnished（T3）. Results Compared with group C, MAP and HR were decreased at T1, T2 and T3 in group D and group P, Ramsay scores were increased in group D and group P （P〈0.05）. Compared with T0, MAP were decreased at T1, T2 and T3 in group D and group P, Ramsay scores were increased at T1 in group D and group P （P〈0.05）. Compared with T0, HR were decreased at T1, T2 and T3 in group D （P〈0.05）. Compared with group D and group P, blood sugar was increased at T1 and T2 in group C （P〈0.05）. Conclusion With using dexmedetomidine, patients with conscious will get good sedative effect in orthopaedic surgery under epidural anesthesia. Using dexmedetomidine can decreased the blood sugar in patients in surgery and inhibit the body＆#39;s stress response.