摘要
目的:探讨右美托咪定联合盐酸羟考酮对胃肠手术老年患者麻醉苏醒期的影响。方法:选择接受胃肠手术的老年男性患者100例,随机分为4组:右美托咪定组(D组)、盐酸羟考酮组(O组)、右美托咪定联合盐酸羟考酮(DO组)和对照组(C组),每组25例。D组手术结束时静脉泵注右美托咪定0.5μg·kg^(-1);O组手术结束时静脉泵注盐酸羟考酮0.07 mg·kg^(-1);DO组手术结束时静脉泵注右美托咪定0.25μg·kg^(-1)+盐酸羟考酮0.04 mg·kg^(-1);C组手术结束时静脉泵注生理盐水。记录苏醒时间和拔管时间;记录不同时点血流动力学指标、疼痛数字评分(numerical rating scale,NRS)和Ramsay镇静评分;记录拔管期呛咳评分、Riker镇静-躁动评分和苏醒期躁动(emergence agitation,EA)发生率;记录药物相关不良反应的发生情况。结果:D组苏醒时间和拔管时间较C组明显延长(P<0.05);与T_0时比较,T_1~T_3时D组和DO组平均动脉压(MAP)、心率(HR)变化不明显;D组和DO组呛咳评分、Riker镇静-躁动评分和EA发生率明显低于C组(P<0.05);DO组NRS评分明显低于、Ramsay镇静评分明显高于C组(P<0.05);D组嗜睡、低血压和心动过缓发生率明显高于C组(P<0.05);O组呼吸抑制发生5例;DO组未发生呼吸抑制、低血压和恶心、呕吐,心动过缓发生1例。结论:手术结束时静脉泵注右美托咪定0.25μg·kg^(-1)和盐酸羟考酮0.04 mg·kg^(-1)可明显减少接受胃肠手术的老年患者的拔管应激反应和苏醒期躁动,镇痛、镇静效果理想,不良反应少。
Objective： To evaluate the effect of dexmedetomidine combined with oxycodone hydrochloride on post-anesthesia in elderly patients with gastrointestinal surgery. Methods： A total of 100 elderly male patients with gastrointestinal surgery were randomly divided into four groups. They were intravenously injected with dexmedetomidine 0. 5 μg·kg（-1）alone,oxycodonehydrochloride 0. 07 mg·kg（-1）alone,dexmedetomidine 0. 25 μg·kg（-1）plus oxycodone hydrochloride 0. 04 mg·kg（-1）,and saline（ control） with minipump at the end of the operation. Recovery time and extubation time were recorded. Hemodynamic index,numerical rating scale（ NRS） and Ramsay sedation score at various time points were assessed. Also the cough score,Riker sedation-agitation scale and emergence agitation（ EA） were observed. The incidence of adverse reactions was recorded. Results： Recovery time and tracheal extubation time were significantly longer in dexmedetomidine group than in control group（ P〈0. 05）. Compared with T0,MAP and HR at T1 T3 did not significant change in dexmedetomidine alone and combination groups. The cough score,Riker sedation-agitation scale and the incidence of EA were significantly lower in dexmedetomidine alone and combination groups than in control group（ P〈0. 05）. Compared with control group,the NRS was signifi-cantly lower and Ramsay sedation score was significantly higher（ P〈0. 05） in combination group. The incidenceof drowsiness,sinus bradycardia and hypotension was significantly higher in dexmedetomidine group than in control group（ P〈0. 05）,respiratory depression occurred in five patients of oxycodone hydrochloride group. In combination group,no nausea,vomiting,respiratory depression and hypotension were found,but sinus bradycardia occurred in one patient. Conclusion： Intravenous injection of dexmedetomidine 0. 25 μg·kg（-1）combined with oxycodone hydrochloride 0. 04 mg·kg（-1）with minipump at the end of the operations can obviously reduce or improve st
出处
《中国新药杂志》
CAS
CSCD
北大核心
2016年第8期903-907,共5页
Chinese Journal of New Drugs
关键词
右美托咪定
盐酸羟考酮
老年患者
苏醒期
dexmedetomidine
oxycodone hydrochloride
elderly patients
recovery period
