摘要
目的评价右美托咪定复合瑞芬太尼在椎间孔镜手术中的应用效果及安全性。方法选取80例在我院行椎间孔镜手术的患者,采取随机数字表法,将其分为2组:右美托咪定复合瑞芬太尼组(D组)和局麻组(L组),每组40例。采用双盲法,D组手术开始前10 min静脉推注右美托咪定1μg/kg和瑞芬太尼0.5μg/kg,随后持续输注右美托咪定0.5μg/(kg·h)+瑞芬太尼0.05μg/(kg·min)。L组常规手术前给予1%利多卡因局麻。记录给药前(T0)、手术开始时(T1)、手术开始10 min后(T2)、手术结束时(T3)、手术结束后30 min(T4)的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)的变化,记录患者手术时间、术中不良反应及并发症,患者和手术医生的满意度;应用Ramsay评分评价患者的镇静效果,并调查患者和骨科医生的满意度。结果 L组T2、T3时,HR、MAP均明显升高(P<0.05);与D组比较,L组镇静效果及医患满意度均明显降低(P<0.05)。结论右美托咪定复合瑞芬太尼应用于椎间孔镜手术安全有效,值得在临床推广。
Objective To evaluate the effects of combined with remifentanil for the sedation of percutaneous transforaminal endoscopy. Methods Eighty patients undergoing percutaneous transforaminal endoscopy were randomly and equally allocated into 2 groups ： patients in group D （ n = 20） was given dexmedetomidine 1 μg/ kg and remifentanil 0. 5 μg/kg followed by remifentanil 0. 05 μg/（kg·min） and dexmedetomidine 0. 5 μg/（kg·h） , patients in group L （ n = 20） was given local anesthesia by 1% lidocaine. The HR, MAP and RR were monitored and recorded before the anesthesia （TO ）, at the time points of operation beginning （T1 ）, 10 min after the beginning of operation （ T2 ）, operation termination （ T3 ） , and 30 min after operation （ T4 ）. The operation time, intraoperative and postoperative incidences of adverse reactions were recorded, the satisfactory degree was recorded too. Results The HR and MAP in group L increased significantly at T2 , T3 （ P 〈 0. 05 ）. Compared with group D, the effect of sedation and the satisfactory degree in group L significantly decreased （ P 〈 0. 05 ）. Conclusion Dexmedetomidine combined with remifentanil is safe and effective in the sedation of percutaneous transforaminal endoscopy.
出处
《实用药物与临床》
CAS
2015年第8期926-928,共3页
Practical Pharmacy and Clinical Remedies
关键词
右美托咪定
瑞芬太尼
椎间孔镜手术
Dexmedetomidine
Remifentanil
Percutaneous transforaminal endoscopy
