右美托咪定自控镇静在眼科斜视手术中的应用效果

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Abstract Objective To investigate the efficacy and safety of Dexmedetomidine for patient-controlled sedation(PCS)in ophthalmologic strabismus surgery.Methods A total of 40 patients with ophthalmologic strabismus who were performed with surgeries in our hospital from October 2016 to October 2017 were selected.They were aged from 16 to 35 years old,with ASAⅠorⅡ,and were randomly assigned to control group(Cgroup)and patient-controlled sedation group(PCS group),with 20 cases in each group.In the control group,normal saline at a constant velocity of 1.0 ml/h was pumped.In the PCSgroup,0.2μg/kg Dexmedetomidine before local anesthesia was intravenously pumped within 10 min.After that,0.1 μg/(kg·h)Dexmedetomidine as a maintenance dose was provided in a single dose of 1.0 ml once (4 μg/ml)at 60 s.The indexes of heart rate(HR),mean arterial pressure(MAP),oxyhemoglobin saturation(SpO2),and Ramsay sedation score before pump loading(T0),end of loading(T1),surgery beginning(T2),5 min during surgery(T3),10 min during surgery(T4),20 min during surgery(T5),30 min during surgery(T6),termination of surgery(T7),degree of cooperation,satisfaction,and the incidence of adverse reactions were compared between two groups.The number of compressions in the PCSgroup was recorded.Results The MAP of T2-T7 in the PCSgroup were lower than that of T0,which was lower than that in the C group,with statistically significant difference(P<0.05).The HR of T1-T7 in the PCSgroup were significantly lower than that of T0,which were lower than that in the C group,and the differences were statistically significant(P<0.05).There was no significant difference between MAP,HR of T1-T7 and T0 in the C group (P>0.05).There was no significant difference in Ramsay sedation scores of T0,T1 and T7 in the two groups(P>0.05).The Ramsay sedation scores of T2-T7 in the PCSgroup were higher than those of T0,and the differences were statistically significant(P<0.05).There were no significant differences in Ramsay sedation scores of T1-T7 and T0 in two groups (P>0.05).The Ramsay sedation score of T7 in the C group was higher than that of T0,and the difference was statistically significant(P<0.05).The Ramsay sedation scores of T2-T6 in the PCSgroup were higher than those in the C group,and the differences were statistically significant(P<0.05).The satisfaction and cooperation of patients in the PCSgroup were better than those in the C group,and the differences were statistically significant(P<0.05).The incidence of discomfort,agitation,and moan in the PCSgroup was significantly lower than that in the C group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of oculocardiac reflex between two groups(P>0.05).After the patients in the PCS group were given a load,the number of effective compressions was (10.7±5.9).Conclusion Dexmedetomidine in PCScan be safely and effectively used in ophthalmologic strabismus surgery.It can fully reflect the individualized medication and the patients′satisfaction is significantly higher.

Key words： Dexmedetomidine Patient-controlled sedation Surgery Strabismus Local anesthesia

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	Articles by authors
	GAO Xin-ming
	CAO He
	DENG Fen-fen
	Karthikeyan Arcot Sadagopan
	Dennis Lam
	WEI Yang

Cite this article:

GAO Xin-ming,CAO He,DENG Fen-fen, et al. Application effect of Dexmedetomidine via patient-controlled sedation in ophthalmologic strabismus surgery[J]. 中国当代医药, 2018, 25(24): 17-21.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I24/17

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