右美托咪啶用于局部麻醉下鼻窦开放术的临床观察.pdf

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1、《中国医学创新》第11卷第1期(总第283期)2014~1月临床研究Linchuangyanjiu右美托咪啶用于局部麻醉下鼻窦开放术的临床观察张佳雷①武杰①韩元福①【摘要】目的：评价右美托咪啶用于局部麻醉下鼻窦开放术的可行性及有效性。方法：60例ASAI～Ⅱ级择期进行鼻内镜下鼻窦开放术患者，按随机数字表法分为对照组(S组)及右美托咪啶组(D组)，每组30例。D组患者于手术开始前l0rain静脉输注右美托咪啶0．5SAg，手术开始后以0．4g／(kg·h)速度持续输注，手术结束前5min停止给药。s组患者给予注射相同剂量的生理盐水。记录入室时(1、0

2、)、手术开始前5min(T1)、手术开始后5min(T2)及鼻窦开放时(T3)的MAP、HR；采足背动脉血测定血浆中去甲肾上腺素(NE)及肾上腺素(E)的浓度；并应用视觉模拟评分法(VAS)判断麻醉满意度。结果：与s组相比，D组T1、112、T3三时间点MAP、HR下降，动脉血中NE及E浓度均降低，差异均有统计学意义(P<0．05)；麻醉满意度评分明显优于S组，差异有统计学意义(P

3、bservationofUsedforLocalAnesthesiainEndoscopicSinusSurgery／ZHANGJia-lei，WUJie，HANYuan—fuJ／MedicalInnovationofChina，2014。11(01)：019-021【Abstract】Objective：Toobservethefeasibilityandefectivenessoflocalanesthesiaassistedwithdexmedetomidineforendoscopicsinussurgery．Method：Sixtypat

4、ients(ASAIorII)underwentthyroidadenomasurgerywererandomlydividedintogroupDandgroupSaccordingtorandomnumbertablemethod，30patientsineachgroup．InthegroupD，thepatientswereintravenouslytreatedwithdexmedetomidine，firstwithloadingdoseof0．5sagwithin10minutesbeforethestartofsurgery，and

5、thenwithmaintainingdoseof0．4(kg‘h)，andwasstopped5minutesbeforetheendofsurgery．ThegroupSwastreatedwiththesamedoseofsaline．MAP，HRwererecordedofpatientsenteredtheoperatingroom(TO)，5minutesbeforethestartofsurgery(T1)，5minutesafterthestartofsurgery(T2)andsinusopeninghours(T3)；colle

6、ctedarterialbloodfromthedorsalispedisarteryin3mL，detectedthelevelsofnorepinephrine(NE)andEpinephrine(E)inarterialblood，andvisualanalogueSCOre(VAS)judgmentsatisfactionofanesthesia．Result：ComparedwiththegroupS，MAPandHRofthegroupsDweredecreased，andNEandEconcentrationsweresignific

7、antlylowerinT1、T2、T3threetimepoints，thediferenceswerestatisticallysignificant(P

8、~bystressresponse，andsafeandeffectivefornasalendoscopicsurger