右美托咪啶对临床硬膜外麻醉术镇静效果及不良反应的临床应用分析(1)
[摘要] 目的 分析右美托咪定对临床硬膜外麻醉术患者的镇定效果，以及临床不良反应的应用价值。 方法 方便选择该院在2016年1月—2017年2月收治的硬膜外麻醉患者84例，随机分成对照组和观察组，每组42例。观察组给持续泵注以及右美托咪定进行治疗，对照组给予泵注和咪达唑仑进行治疗。观察两组患者用药前(T0)、切片即刻(T1)、手术开始15 min(T2)、开始30 min(T3)、开始45 min(T4)和术后(T5)时警觉/镇静(OAA/S)的评分，以及患者出现的不良反应。 结果 实验组患者T1～T4时间段的OAA/S评分分别是(4.1±0.7)分、(3.1±0.6)分、(3.1±0.5)分、(3.4±0.6)分、(4.8±0.5)分，明显比T0(5.0±0.0)分的低，差异有统计学意义(P<0.05)。实验组患者出现的临床不良反应率是35.7%，均低于对照组的45.2%，差异有统计学意义(χ2=10.781，P<0.05)。 结论 对硬膜外麻醉患者使用右美托咪啶能够不抑制患者呼吸，也能缓解患者躁动情况，但是会减缓患者心率，对心脏和心动过缓患者禁止使用。
[关键词] 右美托咪啶；硬膜外麻醉；镇静效果；不良症状
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2018)07(c)-0107-03
Effect of Dexmedetomidine on Clinical Sedative Effect and Adverse Reactions of Epidural Anesthesia
SUN Yu-feng
Department of Anesthesiology， Rugao People's Hospital， Nantong， Jiangsu Province， 226500 China
[Abstract] Objective To analyze the sedative effect of dexmedetomidine on patients undergoing epidural anesthesia and the clinical value of clinical adverse reactions. Methods 84 cases of epidural anesthesia admitted in the hospital from January 2016 to February 2017 were convenient selection and randomly divided into control group and observation group， 42 cases in each group. The observation group gave continuous pump injections and dexmedetomidine for treatment， while the control group received pump injections and midazolam for treatment. Observe the scores of alertness/sedation (OAA/S) in the two groups before treatment (T0)， immediately after slicing(T1)， 15min (T2)， 30min (T3)， 45min (T4) and postoperative (T5)， and the patient's appearance adverse reactions. Results The OAA/S scores of patients in the experimental group were (4.1±0.7)points， (3.1±0.6)points， (3.1±0.5)points， (3.4±0.6)points， (4.8±0.5)points， and the apparent ratio was (5.0±0.0)points， the time was low and the difference was statistically significant (P<0.05). The clinical adverse reaction rate in the experimental group was 35.7%， which was lower than that in the control group (45.2%). The difference was statistically significant (χ2=10.781，P<0.05). Conclusion The use of dexmedetomidine in patients with epidural anesthesia does not inhibit the patient's respiration， but it also relieves the patient's agitation， it slows the patient's heart rate and prohibits use in patients with heart and bradycardia.
[Key words] Dexmedetomidine； Epidural anesthesia； Sedative effect； Adverse symptoms
臨床进行硬膜外麻醉具有很好的镇痛效果，但是患者会出现一些焦虑和紧张的情况，而且在手术中对患者内脏造成的牵拉也会增加患者的应激反应，从而对患者的血流动力学稳定具有一定的影响。所以临床对硬膜外麻醉患者会给予一些镇静药物，缓解患者的不适感，从而提高临床麻醉质量，改善患者预后。右美托咪啶属于一种新型α2肾上腺素能受体激动药，它具有镇痛、催眠、镇静、抑制交感活动、抗焦虑等功能，临床效果显著[1-2]。该文方便选择该院2016年1月—2017年2月接收的48例患者作为分析对象，探讨右美托咪啶对硬膜外麻醉的镇静效果，以及对临床不良反应的改善情况，并获得了良好效果，现报道如下。, http://www.100md.com(孙玉峰)
[关键词] 右美托咪啶；硬膜外麻醉；镇静效果；不良症状
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2018)07(c)-0107-03
Effect of Dexmedetomidine on Clinical Sedative Effect and Adverse Reactions of Epidural Anesthesia
SUN Yu-feng
Department of Anesthesiology， Rugao People's Hospital， Nantong， Jiangsu Province， 226500 China
[Abstract] Objective To analyze the sedative effect of dexmedetomidine on patients undergoing epidural anesthesia and the clinical value of clinical adverse reactions. Methods 84 cases of epidural anesthesia admitted in the hospital from January 2016 to February 2017 were convenient selection and randomly divided into control group and observation group， 42 cases in each group. The observation group gave continuous pump injections and dexmedetomidine for treatment， while the control group received pump injections and midazolam for treatment. Observe the scores of alertness/sedation (OAA/S) in the two groups before treatment (T0)， immediately after slicing(T1)， 15min (T2)， 30min (T3)， 45min (T4) and postoperative (T5)， and the patient's appearance adverse reactions. Results The OAA/S scores of patients in the experimental group were (4.1±0.7)points， (3.1±0.6)points， (3.1±0.5)points， (3.4±0.6)points， (4.8±0.5)points， and the apparent ratio was (5.0±0.0)points， the time was low and the difference was statistically significant (P<0.05). The clinical adverse reaction rate in the experimental group was 35.7%， which was lower than that in the control group (45.2%). The difference was statistically significant (χ2=10.781，P<0.05). Conclusion The use of dexmedetomidine in patients with epidural anesthesia does not inhibit the patient's respiration， but it also relieves the patient's agitation， it slows the patient's heart rate and prohibits use in patients with heart and bradycardia.
[Key words] Dexmedetomidine； Epidural anesthesia； Sedative effect； Adverse symptoms
臨床进行硬膜外麻醉具有很好的镇痛效果，但是患者会出现一些焦虑和紧张的情况，而且在手术中对患者内脏造成的牵拉也会增加患者的应激反应，从而对患者的血流动力学稳定具有一定的影响。所以临床对硬膜外麻醉患者会给予一些镇静药物，缓解患者的不适感，从而提高临床麻醉质量，改善患者预后。右美托咪啶属于一种新型α2肾上腺素能受体激动药，它具有镇痛、催眠、镇静、抑制交感活动、抗焦虑等功能，临床效果显著[1-2]。该文方便选择该院2016年1月—2017年2月接收的48例患者作为分析对象，探讨右美托咪啶对硬膜外麻醉的镇静效果，以及对临床不良反应的改善情况，并获得了良好效果，现报道如下。, http://www.100md.com(孙玉峰)