摘要目的 比较分析不同剂量右美托咪啶对高龄关节置换术患者镇静和镇痛效果。方法 选取2017年4～10月我院收治的高龄关节置换术84例患者，采取分层随机法分成三组，联合组（28例）采取小剂量右美托咪啶负荷+维持，维持组（28例）采取小剂量右美托咪啶维持，对照组（28例）采取生理盐水静脉滴注，比较三组镇静和镇痛效果。结果 联合组及维持组患者用药后、用药后30 min镇静评分均低于对照组，差异有统计学意义（P<0.05）。联合组患者用药后、用药后30 min镇静评分均低于用药后，差异均有统计学意义（P<0.05）。维持组患者用药后、用药后30min镇静评分均低于麻醉后，差异有统计学意义（P<0.05）。联合组及维持组患者用药后、用药后30 min VAS镇痛评分均低于对照组，差异有统计学意义（P<0.05）。联合组及维持组患者用药后、用药后30 min VAS镇痛评分均低于麻醉后，差异均有统计学意义（P<0.05）。联合组及维持组患者用药后30 min VAS镇痛评分均低于用药后，差异均有统计学意义（P<0.05）。对照组患者用药后30 minVAS镇痛评分低于麻醉后，差异有统计学意义（P<0.05）。结论 小剂量右美托咪定持续泵注用于高龄关节置换术中镇静镇痛效果显著，是适宜的手术麻醉方法之一。
Abstract：Objective To compare the sedative and analgesic effects of Dexmedetomidine in different doses in elderly patients with arthroplasty.Methods A total of 84 elderly patients who underwent arthroplasty in our hospital from April to October in 2017 were divided into three groups according to the stratified randomized method.In combination group(n=28),low loading and maintenance doses of Dexmedetomidine was used.In maintenance group(n=28),a small dose of Dexmedetomidine for maintenance was selected.In the control group(n=28),intravenous infusion of saline was adopted.The sedative and analgesic effects among the three groups were compared.Results In both combination and maintenance groups,the sedation scores after medication and 30 min after medication were lower than those in the control group with statistical differences(P<0.05).In the combination group,the sedation scores after medication and 30 min after medication were lower than those after anesthesia,and the sedation score 30 min after treatment were lower than that just after medication(P<0.05).In the maintenance group,the sedation scores after medication and 30 min after treatment were both lower compared with those after anesthesia,which displayed statistical differences(P<0.05).In both combination and maintenance groups,the VAS analgesia scores after medication and 30 min after treatment were significantly lower than those in the control group(P<0.05).Meanwhile,they were all also lower than those after anesthesia(P<0.05).The scores of VAS analgesia 30 min after medication in the combination and maintenance group were lower than those just after medication(P<0.05).In the control group,the VAS analgesia score 30 min after medication was lower in comparison with that after anesthesia with a statistical difference (P<0.05).Conclusion Low-dose Dexmedetomidine in a continuous pump injection for sedation and analgesia in elderly patients with joint replacement can obtain a remarkable effect and is one of the appropriate surgical anesthesia methods.
周吾钊;胡钦擎;李宏青. 不同剂量右美托咪啶对高龄关节置换术患者镇静和镇痛的影响[J]. 中国当代医药, 2018, 25(12): 64-66.
ZHOU Wu-zhao;HU Qin-qing;LI Hong-qing. Effects of Dexmedetomidine in different doses on sedation and analgesia in elderly patients with arthroplasty. 中国当代医药, 2018, 25(12): 64-66.
Fritsch G，Danninger T，Allerberger K，et al.Dexmedetomidine added to ropivacaine extends the duration of interscalene brachial plexus blocks for elective shoulder surgery whencomparedwithropivacainealone：asingle-center，prospective，triple-blind，randomizedcontrolledtrial[J].RegAnesthPain Med，2014，39（1）：37-47.
Prosad BD，Sauvik S，Sanjib P，et al.A comparative study of esmolol and dexmedetomidine on hemodynamic responses to carbon dioxide pneumoperitoneum during laparoscopic surgery[J].Anesth Essays Res，2016，10（3）：580-584.
京公网安备 11010502046607号