摘要
目的观察增加盐酸右美托咪定对不插管全麻下三叉神经射频热凝术治疗三叉神经痛的麻醉效果及安全性。方法抽取60例不插管全麻下施行三叉神经射频热凝术治疗的三叉神经痛患者,随机将其分为A、B组,同时进行BIS监测,两组均静脉注射芬太尼注射液,B组同时微量泵持续泵注右美托咪定。两组间断注射丙泊酚。比较两组的体动反应发生情况、穿刺定位卵圆孔加深麻醉使BIS值降至60时丙泊酚用量、施行射频热凝加深麻醉深度使BIS值降至50时丙泊酚用量、施行射频热凝时需要血管活性药物处理次数、术中呼吸抑制发生情况。结果B组术中体动反应优良率高于A组,差异有统计学意义(P<0.01)。B组在定位卵圆孔、施行射频热凝时异丙酚用量及血管活性药物处理次数均少于A组(P<0.05)。B组术中的呼吸抑制发生率低于A组(P<0.05)。结论在不改变芬太尼用量的情况下,增加右美托咪定的输注可减少丙泊酚的用量及血管活性药物的使用次数,使呼吸抑制及体动反应的发生率明显下降,从而提高三叉神经射频热凝术治疗三叉神经痛的麻醉效果及安全性。
Objective To observe the anesthetic effect and safety of increasing dexmedetomidine hydrochloride in radiofrequency thermocoagulation of trigeminal nerve in the treatment of trigeminal neuralgia under general anesthesia without intubation.Methods Sixty trigeminal neuralgia patients who received trigeminal nerve radiofequency thermocoagulation under general anesthesia without intubation were extracted and randomly divided into group A and B,BIS monitoring was performed simultaneously.The two groups received intravenous fentanyl injection,at the same time,dexmedetomidine was continuously pumped with micropump in the group B.Patients in both groups were intermittent injected propofol.The occurrence of body's dynamic response,propofol dosage when foramen ovale was punctured and to located to deepen anesthesia until BIS value reduced to 60,propofol dosage when radiofrequency thermocoagulation was implemented to deepen anesthesia until BIS value reduced to 50,the times of vasoactive drug treatment when radiofrequency thermocoagulation was implemented,and the occurrence of intraoperative respiratory depression in the two groups were compared.Results The excellent and good rate of intraoperative body's dynamic response in the group B was higher than that in the group A,and the difference was statistically significant(P<0.01).The propofol dosages when foramen ovale was located and radiofrequency thermocoagulation was implemented,the times of vasoactive drug treatment in the group B were less than those in the group A(P<0.05).The incidence of intraoperative respiratory depression in the group B was lower than that in the group A(P<0.05).Conclusion Increasing the infusion of dexmedetomidine without changing the dosage of fentanyl can reduce the dosage of propofol and the utilization times of vasoactive drugs,significantly reduce the incidences of respiratory depression and body's dynamic response,thus improving the anesthetic effect and safety of radiofrequency thermocoagulation of trigeminal nerve in the treatment of trige
作者
邵建强
罗晓艳
曾晨
SHAO Jian-qiang;LUO Xiao-yan;ZENG Chen(Yangling Demonstration Zone Hospital,Yangling 712100,China)
出处
《临床医学研究与实践》
2020年第16期74-76,共3页
Clinical Research and Practice
关键词
盐酸右美托咪定
三叉神经
射频热凝术
dexmedetomidine hydrochloride
trigeminal nerve
radiofrequency thermocoagulation
