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1、盐酸右美托咪定用于老年晶体植入手术的临床观察盐酸右美托咪定用于老年品体植入手术的临床观察[摘要]目的比较不同剂量的右美托咪定(DEX)用于老年晶体植入术中的安全性和有效性。方法ASAI或II级择期行品体植入手术的老年患者92例,随机均分为低剂量右美托咪定组(D1组)、中剂量右美托咪定组(D2组)、高剂量右美托咪定组(D3组)、咪达卩坐仑组(M组)。D1组,DEX0.4pg/kg,用生理盐水稀释成20mL,静脉泵注lOmin,D2组,DEX0.7ug/kg,给药方法同D1组;D3组,DEXl.Oug/kg,给药方法同D1组;M组手术开始前
2、lOmin输注咪达哇仑0.03mg/kgo观察记录患者麻醉前(TO)、用药后10min(T1)、15min(T2)、30min(T3)、60min(T4)平均动脉压(MAP)、心率(HR)、RR(呼吸次数)、血氧饱和度(SpO2)。同时观察三组术中、术后不良反应及医生和患者满意度。结果与麻醉前比较,D组患者MAP、HR有显著性差异(P<0.05)oD2、D3组术中体动发生率、术后请妄的发生率、低于D1组(P<0.05)和M组(P〈0・05)。D组医生和患者满意度高于M组(P〈0・05)。结论中、高剂量右美托咪定应用于晶体植入手术患者安全
3、有效;镇静镇痛效果好;术中、术后不良反应发生率低且医师和患者满意度高。[关键词]右美托咪定;咪哩安定;晶体植入手术[中图分类号]R971[文献标识码]B[文章编号]2095-0616(2013)22-96-03ClinicalobservationofdexmedetomidineonagedpatientundergoingcataractextractioncombinedwithintraocularlensimplantationTIANYunpingLIBeipingMAXingduiDepartmentofAnesthesi
4、ology,theFirstPeople,sHospitalofXuzhouCity,Xuzhou221000,China[Abstract]ObjectiveToobservethesafetyandefficacyofdexmedetomidineonagedpatientsundergoingcataractextractioncombinedwithintraocularlensimplantation.Methods92patients(ASAIorII)wererandomlydividedintofourgroups,wi
5、th23casesineachgroup(n二23),midazolamgroup(groupM)low-doseDEXgroup(DIgroup),medium-doseDEXgroup(D2group),high-doseDEXgroup(D3group)・MAP,HR,RR,SpO2wererecordedbeforeanesthesia,after10minbegininfusionofDEXand15,30and60minAtthesametime,thedegreeofsatisfactionofdoctorsandpati
6、entswererecorded・ResultsInDEXgroups,HRandMAPdecreasedsignificantlyatT1-T3comparedwithTO(P<0.05)・TheincidenceofadversereactionwassignificantlyloweringroupD2andgroupD3ComparedwithgroupDI(P<0.05)andgroupM(P<0.05)・Atthetimes,thedegreeofsatisfactionofdoctorsandpatientsWashigh
7、erthanDIgroup(P<0.05),Mgroup(P<0.01).ConclusionAgedpatientsundergoingcataractextractioncombinedwithintraocularlensimplantationissafeandeffective;Calmanalgesictheeffectforsedationandanalgesiaisgood;Theincidenceofadversereactionofperioperativeandpostoperativeisloweranddoct
8、orsandpatientssatisfactionishigher・[Keywords]Dexmedetomidine;Midazolam;Cataractextractionintraocularlen