摘要
目的观察右美托咪定（Dex）麻醉在糖尿病眼底出血合并高血压患者行玻璃体切除术中的应用效果。方法60例择期手术患者，随机分为右美托咪定组（D组）、咪唑安定复合芬太尼组（F组），每组30例。2组患者均行球周阻滞麻醉，记录2组患者术中的收缩压和舒张压（SBP、DBP）、心率（UR）、呼吸频率（RR）、脉搏血氧饱和度（SpO：）、Ramsay镇静评分、视觉模拟法（VAS）疼痛评分以及术中眼心反射、躁动和术后恶心呕吐等不良反应及血管活性药物的应用情况。结果D组术中SBP、DBP、HR较麻醉前下降，镇静评分、疼痛评分升高（P〈0．05）；F组术中SBP、HR、镇静评分、疼痛评分较麻醉前升高（P〈0．05），有10例患者使用血管活性药物。2组比较：D组SBP、DBP、HR较F组低（P〈0．05），D组的镇静评分较F组高（P〈0．05），D组镇痛评分较F组低（P〈0．05），D组患者术中躁动及术后恶心的发生率较F组少（P〈0．05）。结论右美托咪定用于高血压患者玻璃体切除术时镇静、镇痛效果好，循环稳定，不良反应少。
Objective To investigate the effects of dexmedetomidine on hemodynamics and sedation in fnndus hemorrhage patients with diabetes and hypertension undergoing vitrectomy. Methods 60 senile patients with diabetes and hypertension scheduled for elective vitrectomy under peribulbar anesthesia were enrolled and randomly assigned to dexme- detomidine group （ group D, n = 30） and midazolam combined with fentanyl group （ group F, n = 30）. Systolic blood pressure （SBP） , diastolic blood pressure （DBP）, heart rate （HR） , respiration rate （RR） and pulse oxygen saturation （SpO2） in both groups were observed. The visual analogue scale （VAS） and ramsay sedation score （RS） and dosage of vasoactive drugs were recorded. Intraoperative adverse reactions such as oculocardiac reflex, restlessness, postoperative nausea and vomiting were assessed. Results Compared with pre - anesthesia, intraoperative SBP, DBP and HR were decreased （ P 〈 0.05 ）, RS and VAS score were higher （P 〈 0.05 ） in group D ; whereas patients in group F, SBP, HR, RS and VAS score were increased （ P 〈 0.05 ）. Furthermore, 10 patients required vasoactive agents. There was signifi- cant difference in SBP, DBP, HR, RS and VAS score between group D and group F （P 〈 0.05 ）. The incidence of intra- operative restlessness and postoperative nausea in group D were significantly lower than that of group F （ P 〈 0.05 ）. Conclusion Monitored anesthesia care under dexmedetomidine can provide optimal sedation, analgesia, stable hemodynamics and less adverse reactions in patients with diabetes and hypertension undergoing vitrectomy.
出处
《徐州医学院学报》
CAS
2012年第8期546-549,共4页
Acta Academiae Medicinae Xuzhou
关键词
右美托咪定
监护麻醉
玻璃体切除术
高血压
dexmedetomidine
monitored anesthesia care（MAC）
vitrectomy
hypertension
