摘要
目的比较术前肌注右美托咪啶或咪达唑仑对老年患者胃癌或肠癌根治术后恢复的影响匸方法纳入择期行胃癌或肠癌根治术的老年患者120例,随机分为右美托咪啶组(D组)、咪达唑仑组(M组)和对照组(C组),每组40例。D组术前肌注0. 6μg/kg右美托咪啶,M组术前肌注0.02mg/kg咪达唑仑,C组术前肌注相同体积的0. 9% NaCl溶液.1 h后分别采用Ramsay镇静评分和语言数字评分评估患者镇静和焦虑程度.手术麻醉结束后,随访记录患者急性谵妄和术后恢复状况结果与C组相比,D组和M组Ramsay镇静评分明显升高(P < 0. 05 ),焦虑评分明显下降(P < 0. 05 ),但D组和M组间差异无统计学意义(P>0.05)。同时.3组术后住院天数、术后请妄发生率、下床活动起始时间、排气起始时间、经口摄食起始时间、并发症发生率和死亡率相比较差异无统计学意义(P>0.05).结论术前肌注右美托咪啶或咪达唑仑在获得相同良好的镇静和抗焦虑基础上,并不影响老年患者胃癌或肠癌根治术后恢复。
Objective To campare the effects of premedication of dexmedetomidine versus midazolam on postoperative recovery in older patients underwent radical resection for gastrointestinal cancer. Methods 120 older patients underwent selective gastrointestinal surgery- were enrolled in this study. The patients were ramdonilv assigned to dexmetomidine group ( Group D ), midazolam group ( Group M ) and control group ( Group C), 40 patients in each group. Group D received intramuscular premedication of dexmedetomidine 0. 6 |ig/kg. Group M received intramuscular preinedication of midazolam 0. 02 mg/kg. Group C received the same volume of saline. At 1 h after adniinistration of drugs, the Ramsay sedation score and verbal numerical scale were respectively used to evaluate sedation and anxiety. The incidence of acute postoperative delirium and postoperative recovery were recorded. Results Compared with group 0 , the Ramsay sedation score in group D and group M were significantly increased ( P < 0. 05 ), while the verbal numerical scale in both groups were significantly decreased (P<0. 05 ). However, there were no significant differences between group 1) and group M ( P > 0. 05 ). The postoperative hospital stay, incidence of acute postoperative delirium, time lo mobility, time to first flatus, time to oral intake, in cidences of complication and mortality among three groups showed no signified nt differences ( P〉 0. 05 ). Conclusion Piemedication with dexmedetomidine or midazolam do not affect postoperative recovery in the context of similar good sedation and anti - anxiety in older patients underwent radical resection for gastrointestinal cancer.
作者
乐国辉
雷月
王欢峰
张代玲
Le Guohui;Lei Yue;Wang Huanfeng;Zhang Dailing(Department of Anaesthesia, Traditional Chinese Medicine Hospital of Kunshan , Kunshan 215300 , China)
出处
《国际老年医学杂志》
2019年第2期81-84,共4页
International Journal of Geriatrics
基金
江苏省昆山市社会发展科技专项(KS1556)
关键词
右美托咪啶
咪达唑仑
术前用药
术后恢复
Dexmedetomidine
Midazolam
Preinedication
Postoperative recoveiy
