摘要
目的观察右美托咪定用于老年患者脊椎-硬膜外麻醉辅助镇静时脑电双频指数(BIS)与Ramsay镇静评分(RSS)的相关性。方法选取拟行膝关节置换术患者120例,均行脊椎-硬膜外麻醉,随机分为两组,每组60例。对照组给予丙泊酚1 mg·kg^(-1)静脉输注5 min后以2 mg·kg^(-1)·h^(-1)持续泵注;试验组给予右美托咪定1μg·kg^(-1)静脉输注10 min后以0.5μg·kg^(-1)·h^(-1)持续泵注。记录入室时(T_0),椎管内麻醉后10 min(T_1),给药后5 min(T_2)、10 min(T_3)、20 min(T_4)、40 min(T_5)、60 min(T_6),术毕(T_7)和术后1 h(T_8)的心率(HR)、平均动脉压(MAP)、BIS值、RSS和不良反应发生情况,采用Spearman秩相关性检验分析RSS与BIS的相关性。结果两组T_3~T_5时的HR均较T_0时降低(P<0.05),且试验组HR低于对照组(P<0.05)。两组T__2~T__5时的MAP均较T_0时降低(P<0.05),且对照组MAP低于试验组(P<0.05)。两组镇静深度均满足手术要求,对照组和试验组的BIS值与RSS均呈负相关性(P<0.05),r值分别为-0.85和-0.88。试验组呼吸抑制、低血压和躁动发生率低于对照组(P<0.05)。结论较丙泊酚,右美托咪定辅助老年患者镇静时不良反应发生少,BIS与RSS相关性良好并能够达到使用丙泊酚时的水平,BIS是评价镇静深度的良好客观指标。
aged ; dexmedetomidine ; propofol ; bispectral index ; Ramsay sedation score[ ABSTRACT] AIM To investigate the correlation between bispectral index （BIS） and Ramsay sedation score （RSS） in elderly patients under spinal- epidural anesthesia during sedation with dexmedetomidine. METHODS A total of 120 elderly patients scheduled for elective knee arthroplasty under spinal- epidural anesthesia were collected. The patients were randomly divided into two groups （n --- 60 each）. In the control group, propofol μg·kg-1 was infused over 5 minutes, and followed by 2 μg·kg-1 infusion during maintenance. In the trial group, dexmedetomidine 1μg·kg-1 was infused over 10 minutes intravenously, and followed by 0.5 μg·kg-1·h-1 infusion during maintenance. Heart rate （HR）, mean arterial pressure （MAP）, BIS, RSS and adverse reactions were recorded at entering the operation room （To）, 10 min after spinal anesthesia （T1）, 5 min （T1）, 10 min （T3）, 20 min （T4）, 40 min （Ts） and 60 min （T6） after intravenous infusion, the end of operation （T7） and 1 h after operation （Ts）. Spearman rank correlation test was used to analyze the correlation between RSS and BIS. RESULTS HR were lower at T3-T5 than those at To in both groups （P 〈 0.05）, and were significantly lower in the trail group than the control group （P 〈 0.05）. MAP were lower at T2-T5 than those at To in both groups （P 〈 0.05）, and were significantly lower in the control group than the trial group （P 〈 0.05）. Sedation was satisfied for operation in both groups. Good negative correlation existed between the BIS and the RSS in the control group and trial group （P 〈 0.05）, and the r values were -0.85 and -0.88 respectively. Incidence of respiratory depression, hypotension and restlessness was lower in the trail group than in the control group （P 〈 0.05）. CONCLUSION Compared with propofol, incidence of adverse reactions is lower in sedation with dexmedetomidine. Good correlation exists betw
出处
《中国新药与临床杂志》
CSCD
北大核心
2017年第5期283-287,共5页
Chinese Journal of New Drugs and Clinical Remedies
基金
河北省医学科学研究重点课题计划(ZL20140225)
