摘要
目的 研究羟考酮复合右美托咪定辅助颈丛神经阻滞下甲状腺切除手术麻醉的临床效果。方法 将ASAⅠ~Ⅱ级60例行甲状腺切除的患者随机分为羟考酮复合右美托咪定组（D组）和右美托咪定组（C组）,各30例。D组取羟考酮5 mg于颈丛神经阻滞前10 min缓慢静注,随后静脉注射负荷量的右美托咪定0.5μg/kg,输注时间10 min,继续以0.2μg/（kg·h）速度持续泵注维持至缝皮;C组不予注射羟考酮,其他用药一致。监测记录两组患者T0、T1、T2及T3时点的平均动脉压（MAP）、心率（HR）、麻醉满意度。结果 两组T0时点MAP、HR差异均无统计学意义（P均〉0.05）。T1、T2、T3时点,两组MAP、HR差异均有统计学意义（P均〈0.05）;在T2及T3时点,C组MAP、HR明显高于T1时点,差异均有统计学意义（T2与T1时点MAP比较,t=10.527,P〈0.05,与T1时点HR比较,t=12.712,P〈0.05;T3与T1时点MAP比较,t=11.245,P〈0.05,与T1时点HR比较,t=10.155,P〈0.05）。D组患者满意度高于C组,差异有统计学意义（P〈0.05）。结论 羟考酮复合右美托咪定辅助用于颈丛神经阻滞麻醉能够减轻甲状腺切除术术中应激反应所导致的血流动力学变化。
Objective To explore the clinical effect of oxycodone combined with dexmedetomidine in anesthesia of thy- roid surgery under cervical plexus nerve block. Methods A total of 60 patients who were given thyroideetomy with ASA Ⅰ to Ⅱ grade were randomly divided into oxyeodone combined with dexmedetomidine group （group D） and dexmedetomi- dine group （group C）, each with 30 cases. Patients in group D were given oxycodone 5 mg i.v. at 10 rain before cervical plexus nerve block, and then given intravenous injection of load capacity of dexmedetomidine 0.5 μg/kg for 10 min, which was continuously pumped at 0.2 μg/（kg＇h） until skin closure. Patients in group C were given same procedures except that of oxyeodone. The MAP, HR, and satisfaction of anesthesia at TO, T1, T2, and T3 were monitored and recorded. Results There was no significant difference in MAP or HR at TO between two groups（P〉0.05）. At T1, T2, and T3, there were significant differences in MAP and HR between two groups （P〈0.05）. The MAP and HR of group C were signifi- cantly higher at T2 and T3 than T1 （MAP： T2 vs T1, t=10.527, P〈0.05,T3 vs T1, t=11.245, P〈0.05, HR： T2 vs T1, t= 12.712, P〈0.05;T3 vs T1, t=10.155, P〈0.05）. The satisfaction in group D was significantly higher than that in group C （P〈0.05）. Conclusion Application of oxyeodone combined with dexmedetomidine in anesthesia of thyroid surgery under cervical plexus nerve block can relieve the hemodynamic change easued by stress reaction.
出处
《中国现代医生》
2016年第23期104-106,共3页
China Modern Doctor
