右美托咪定不同给药途径影响手术患者临床疗效的研究

目的 比较右美托咪定静脉给药和硬膜外给药用于连续硬膜外麻醉的辅助镇静效果.方法 选择本院连续硬膜外麻醉手术的患者100例,随机分为连续硬膜外麻醉辅助右美托咪定静脉给药组（Ⅰ组）和连续硬膜外麻醉辅助右美托咪定硬膜外给药组（P组）.比较麻醉起效时间、达峰时间及麻醉平面消退时间,同时比较用药前、用药后5、15、30 min两组患者平均动脉压以及心率变化情况,并观察不良反应.结果 P组麻醉起效时间较Ⅰ组更快,消退时间更慢（P＜0.05）.静脉途径给药患者MAP下降较椎管内给药更迅速（P＜0.05）,但两组所达低峰值之间差异无显著性.静脉给药与椎管内给药心率降低的时间基本一致.两种途径的不良反应发生率无显著性差异.结论 右美托咪定静脉给药和硬膜外给药都能较好地辅助硬膜外麻醉镇静,静脉给药对镇静的可控性比椎管内给药更方便.

Research on the different routes of dexmedetomidine on the effect of patients with clinical surgery

Objective To compare the secondary sedative effect of dexmedetomidine with intravenous and epidural ad- ministration for the continuous epidural anesthesia. Methods One hundred patients in our hospital under continuous epidural anesthesia surgery were randomly divided into continuous epidural anesthesia assisted dexmedetomidine with intravenous group （I group） and continuous epidural anesthesia care assisted dextromethorphan with epidural group （P group）. Comparison of anesthesia onset time, peak time and the time of anesthesia subsided, the former simultaneously compare medication, 5, 15, 30 minutes after administration of the two groups of patients in mean arterial pressure and heart rate changes, adverse reactions were observed. Results P group onset time of anesthesia was faster than the I group, regression time was slower （P〈0.05）. Patients intravenous route MAP decreased was more rapidly than the intraspinal administration （P〈0.05）, hut the differences between the two groups were no significant of the lower peak. Intravenous drug delivery and the dosing rate reduce intraspinal canal had almost the same time. There were no significant differ- ence of the adverse reaction rate of two ways. Conclusion The sedative dexmedetomidine with intravenous and epidural administration can give better assist epidural anesthesia, intravenous sedation administered is more easily controllable than the spinal canal.