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《不同剂量右美托咪定在连续硬膜外麻醉术中的临床应用.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、哈尔滨医药20l4年第34卷第4期·265·不同剂量右美托咪定在连续硬膜外麻醉术中的临床应用葛凤敏,卓海珍,刘新,姚业兴(广东医学院附属医院,广东湛江524001)摘要目的对比不同剂量右美托咪定在连续硬膜外麻醉术中的镇静效果。方法选取择期在连续硬膜外麻醉下行中下腹部手术的患者80例,ASAI一Ⅱ级,按随机数字表法分为4组,每组20例:0.2kg剂量实验组(s。)、0.5g/kg剂量实验组(S2)、0.8kg剂量实验组(S3)和对照组(D)。记录患者麻醉前(To)、用药后5min(T1)、15min(T2)、30min(T3)、60min(T)、术毕(T5)的MAP、HR、S
2、pO2及OAA/S评分。结果OAA/S镇静评分显示s组各组较D组具有显著的镇静效果(P<0.05),与剂量呈正相关;血流动力学指标(HR和MAP)比较,s各组均有下降,且s2、s3组的下降较sl组明显,D组上升,s组间与D组的两两比较差异有统计学意义(P<0.05);D组的不良反应发生率均明显高于S各组,差异有统计学意义(P<0.05)。结论右美托咪定在连续硬膜外麻醉术中具有良好的辅助镇静效果,且与剂量呈正相关;0.2g/kg的小剂量组疗效确切,对血液动力学的影响和副反应较中、高剂量组小。关键词不同剂量;右关托咪定;连续硬膜外麻醉;镇静[中图分类号]R451[文献标识码]A
3、学科分类代码:32021文章编码:100l一8131(2014)04—0265—03Di船erentDosesofDexmedetomidineAnesthesiaf0rClinicalApplicationinContinuousEpiduralGEFengmin,ZHU0Haizhen,LIUXin,YAOYexing(AffiliatedHospitalofGuangdongMedicalCollege,Zhanjiang524001,China)AbstractObjectiveComparisonofdiferentdosesofdexmedetomidinein
4、anesthesiasedationduringepidura1.MethodsMeth—ods80patientsundergoinglowerabdominaloperationundergeneralanesthesiaincontinuousepiduralanesthesia,ASAgradeI一Ⅱ,wererandondydividedinto4groups,20caseseachgroup:0.2kgdoseexperimentalgroup(S1),0.5kgdoseexperimentalgroup(S2),0.8kgdoseexperimentalgro
5、up(S3)andcontrolgroup(D).Recordsofpatientsbeforeanesthesia(To),afteradminis。trationof5min(T1),15min(T2),30min(T3),60min(T4),endofoperation(T5)ofMAP,HR,SpO2andOAA/SSCO.ResultsOAA/SsedationscoreshowedthatSgroupthaninDgrouphadasignificantsedativeefect(P<0.05),anddose—dependent;hemodynamicinde
6、xes(HRandMAP),Sineachgroupweredecreased,andthedecreasedS2,S3groupwashigherthanthatingroupSl,Dwerein—creased,ShadstatisticalsignificancebetweengroupandgroupDthetwotwodiference(P<0.05);theadversereactionrateinDgroupweresignificantlyhigherthanthatinSgroup,thedifferencewasstatisticalysignifica
7、nt(P<0.05).ConclusionDexmedetomi—dineincontinuousepiduralanesthesiawithsedationduringoperationandgoodefect,anddose—dependent;smalldoseefectof0.2kgexactly,thehemodynamicefectsandsideeffectsofhighdosegroupthaninsmal1.KeywordsDifferent—dose;Dexmedetomidine;Contin
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