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右美托咪定在老年脊柱骨科手术全身麻醉中的临床效果 预览 被引量:1

Clinical Effect of Dexmedetomidine on General Anesthesia of Elderly Spine Orthopedics
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摘要 目的研究与分析右美托咪定在老年脊柱骨科手术全身麻醉中的临床效果。方法选取自2015年3月至2016年12月经我院收治拟行全身麻醉老年脊柱骨科患者70例,并按数字表法随机分为对照组33例与观察组37例。对照组患者实施常规麻醉诱导,观察组则在实施麻醉诱导前15 min内静脉泵入0.5 ug/kg右美托咪定。麻醉诱导可视喉镜下完成气管插管,同时以0.4 ug/(kg.h)速度持续泵注至椎弓根螺钉连接棒成功置入,缝合腰背肌筋膜止。术中以丙泊酚和瑞芬太尼持续输注维持麻醉,维持术中脑电双频谱指数(BIS)为40~60。对比分析两组患者术中药物使用量、手术前后MMSE评分、不同时间点内的平均动脉压及术后苏醒时间。结果观察组术中丙泊酚(385.4±53.5)mg、舒芬太尼(28.1±6.1)μg、依托咪酯(11.7±3.6)mg、瑞芬太尼(1532±362)ug用量明显少于对照组丙泊酚(529.7±89.2)mg、舒芬太尼(37.9±7.6)μg、依托咪酯(18.2±5.4)mg、瑞芬太尼(1882±399)ug用量;术后,观察组MMSE评分(25.76±1.52)分明显高于对照组(21.33±3.34)分;在T3、T4、T6时间点内,两组平均动脉压相比,差异有统计学意义(P〈0.05)。手术主要操作(椎弓根螺钉连接棒成功置入,缝合腰背肌筋膜)完成,停注右美托咪定,两组患者苏醒时间无明显差异(P〉0.05)。结论老年脊柱骨科手术中使用右美托咪定,可有效减少丙泊酚、舒芬太尼、瑞芬太尼、依托咪酯用量,维持血流动力学稳定,提高患者术后认知水平,苏醒时间无明显差异。 Objective To study and analyze the clinical effect of dexmedetomidine on general anesthesia of Elderly Spine Orthopedic surgery. Methods Seventy elderly patients with spinal orthopedics surgery who underwent general anesthesia in our hospital from March2015 to December 2016 were selected, and randomly divided into the control group(n=33) and the observation group(n=37). The patients in the control group, routine anesthesia induction was performed. In the observation group, intravenous infusion of 0.5 ug/kg dexmedetomidine was performed 15 min before the induction of anesthesia, followed by a maintenance infusion of 0.4 ug/(kg·h)until the Pedicle screw fixation connection rod successfully placed, stitched back myofascial. Propofol and remifentanil were pumped intravenously to maintain the Bispectral index(BIS)40~60. Comparison of the two groups of patients with intraoperative drug dosage, MMSE score before and after surgery, mean arterial pressure at different time points and postoperative recovery time. Results The drug dosage of propofol(385.4 ±53.5)mg, sufentanil(28.1 ±6.1)ug, Etomidate(11.7 ±3.6)mg, Remifentanil(1532 ±362)ug, in the observation group were significantly lower than that of the control group propofol(529.7±89.2)mg, sfentanil(37.9±7.6)ug, Etomidate(18.2±5.4)mg, Remifentanil(1882±399)ug; The postoperative MMSE score in the observation group(25.76 ±1.52) was significantly higher than that of the control group(21.33±3.34); There were significant differences in mean arterial pressure at T3,T4 and T6 time points between twogroups(P 0.05).Major surgical operation was completed(the Pedicle screw fixation connection rod successfully placed, stitched back myofascial) to stop intravenous dexmedetomidine, there was no significant difference in recovery time between the two groups(P 0.05). Conclusions The application of dexmedetomidine in elderly spinal orthopedics surgery can effectively reduce the dosage of anesthetics and improv
作者 刘美跃 王召红 徐广辉 张清 LIU Meiyue1, WANG Zhaohong1, XU Guanghui2, ZHANG Qing1 ( 1Department of Anesthesiology and orthopedics of Zhabei Central Hospital, Jing'an District, Shanghai, 200070)
出处 《新疆医学》 2017年第11期1262-1264,1268共4页 Xinjiang Medical Journal
基金 上海市医学会麻醉分会新晨杯青年麻醉医师培育基金(2015002001)
关键词 右美托咪定 老年 脊柱骨科 术后认知水平 BIS Dexmedetomidine Elderly Spinal Orthopedics Cognitive Level BIS
作者简介 刘美跃,男,主治医师,研究方向:麻醉学。;通信作者:张清,女,硕士,主任医师,研究方向:麻醉学,E-mail:13701989836@163.com。
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