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术中静脉应用不同剂量右美托咪定对老年患者术后硬膜外吗啡镇痛的影响 预览 被引量:18

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摘要 目的观察术中静脉应用不同剂量右美托咪定对行腹式全子宫切除术的老年患者术后吗啡硬膜外自控镇痛(PCEA)的影响及相关不良反应发生的情况。方法择期行经腹子宫全切术病人48例,患者腰硬联合麻醉成功后,采用数字随机分组法分为四组各12例:对照组、D1组(右美托咪定组1μg/kg)、D2组(右美托咪定组2 g/kg)和D3组(右美托咪定组3 g/kg)。对照组给予生理盐水50 ml在1 h内输注完毕,右美托咪定各组计算好总量后生理盐水稀释至50 ml静脉1 h内输注完毕。术后使用吗啡行患者PCEA,观察术后24 h镇痛情况。记录术后12 h和12~24 h的吗啡用量、电子镇痛泵(PCA)泵总按压次数和有效按压次数;分别于术后0.5、2、6、12、24 h时,采用视觉模糊(VAS)评分法评价静息状态和活动状态下的疼痛程度,计算镇痛有效率;记录围术期心动过缓、低血压的发生情况和阿托品、麻黄碱的使用情况及镇痛期间恶心、呕吐、皮肤瘙痒等不良反应的发生情况。结果术后12 h吗啡用量、PCA总次数和有效次数D1、D2、D3组较对照组减少(P【0.05),D2组和D3组较D1组减少(P【0.05),D2组和D3组比较无统计学差异(P】0.05);术后12~24 h四组患者吗啡用量、PCA总次数和有效次数无统计学差异(P】0.05)。四组患者静息状态下镇痛有效率差异无统计学意义(P】0.05);D1、D2和D3组运动状态下镇痛有效率较对照组升高(P【0.05),D2组和D3组较D1组升高(P【0.05),D2组和D3组差异无统计学意义(P】0.05)。围术期心动过缓的发生次数和阿托品的使用量,D1、D2和D3组较对照组增加,D3组较D1和D2组增加(P【0.05),D1组和D2组差异无统计学意义(P】0.05);低血压的发生次数和麻黄碱的使用量,D3组较其余三组增加(P【0.05),其余三组之间差异无统计学意义(P】0.05)。对照组出现恶心发生率较其余三组增加(P【0.05),其余三组之间无统计学意义(P】0.05),余不良反�
出处 《中国老年学杂志》 CAS CSCD 北大核心 2014年第3期678-680,共3页 Chinese Journal of Gerontology
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参考文献5

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共引文献36

同被引文献186

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