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右美托咪定在脊柱侧凸矫形术中的应用 被引量:5

Application of Dexmedetomidine in Scoliosis Surgery
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摘要 目的观察右美托咪定对脊柱侧凸矫形术患者唤醒质量、血流动力学和术后寒战的影响。方法选择行脊柱侧凸矫形术患者40例,ASAⅠ-Ⅱ级,按随机数字表法分为右美托咪定组(D组)和对照组(C组),每组20例。D组诱导前给予右美托咪定0.5μg.kg-1静脉输注(10min输注完),继予0.5μg.kg-1.h-1速率输注至缝合切口;C组输注相同剂量生理盐水。唤醒试验开始前15min停止泵注所有麻醉药,唤醒试验结束后继续泵注。记录唤醒及麻醉苏醒时间、手术持续时间、术中相应时点平均动脉压(MAP)和心率(HR),使用血管活性药以及术后寒战发生情况,并对唤醒质量进行评价。结果 2组患者唤醒和苏醒时间差异无统计学意义(P>0.05),唤醒质量D组优于C组(P<0.05)。麻醉后各时点MAP和HR D组均低于C组(P<0.05);且术后寒战发生率D组少于C组(P<0.05)。结论在脊柱侧凸矫形术中持续输注小剂量右美托咪定能提高术中唤醒质量、维持患者血流动力学稳定,并可降低术后寒战发生率。 Objective To observe the effects of dexmedetomidine on arousal quality,hemodynamics and postoperative shivering in patients undergoing scoliosis surgery.Methods Forty patients scheduled for posterior scoliosis correction(ASA Ⅰ-Ⅱ,aged 10-25 years) were randomly divided into two groups,with 20 patients in each group.Group D was given intravenous injection of dexmedetomidine(0.5 μg·kg-1) within 10 minutes before induction,followed by an intraoperative infusion of dexmedetomidine(0.5 μg·kg-1·h-1) until the incision was sutured.Group C was only infused with an equal volume of normal saline.All infusions were discontinued at 15 minutes before awaken test,and restored after the test.Surgery duration,wake-up time,awakening time from anesthesia,intraoperative mean arterial pressure(MAP) and heart rate(HR) were recorded.Moreover,arousal quality,use of vasoactive drugs and postoperative shivering were determined.Results There were no significant differences in arousal time and awakening time from anesthesia between the two groups(P0.05).Compared with group C,intraoperative infusion of dexmedetomidine significantly increased arousal quality and decreased MAP,HR and postoperative shivering rate(P0.05).Conclusion Continuous infusion of small doses of dexmedetomidine can improve arousal quality,maintain hemodynamic stability and reduce the incidence of postoperative shivering in scoliosis surgery.
出处 《南昌大学学报(医学版)》 CAS 2012年第2期55-57,60,共4页 Journal of Nanchang University:Medical Sciences
关键词 脊柱侧凸矫形术 右美托咪定 唤醒质量 血流动力学 寒战 scoliosis surgery dexmedetomidine arousal quality hemodynamics shivering
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参考文献7

  • 1Sinclair M D. A review of the physiological effects of αlpha2-agonists related to the clinical use of medetomidine in small animal practice[J].Canadian Veterinary Journal-Revue Veterinaire Canadienne,2003,(11):885-897.
  • 2Baiwa S J,Arora V,Singh A. Comparative evaluation of dexmedetomidine and fentanyl for epidural analgesia in lower limb orthopedic surgeries[J].Saudi J Anaesth,2011,(04):365-370.
  • 3Miller R D. Miller's Anesthesia[M].New York:Churchill livingstone,2005.2418-2419.
  • 4Carollo D S,Nossaman B D,Ramadhyani U. Dexmedetomidine:a review of clinical applications[J].Current Opinion in Anaesthesiology,2008,(04):457-461.
  • 5Nelson L E,Lu J,Guo T. The α2-adrenoceptor agonist dexmedetomitine converges on an endogenous sleep-promoting pathway to exert its sedative effects[J].Anesthesiology,2003,(02):428-436.doi:10.1097/00000542-200302000-00024.
  • 6Correa Sales C,Rabin B C,Maze M. A hypnotic response to dexmedetomidine,an αlpha-2 agonist,is mediated in the locus corruleus in rats[J].Anesthesiology,1992,(06):948-952.
  • 7Bicer C,Esmaoglu A,Akin A. Dexmedetomidine and meperidine prevent postanaesthetic shivering[J].European Journal of Anaesthesiology,2006,(02):149-153.doi:10.1017/S0265021505002061.

同被引文献59

  • 1李民,张利萍,吴新民.右美托咪啶在临床麻醉中应用的研究进展[J].中国临床药理学杂志,2007,23(6):466-470. 被引量:483
  • 2施冲,吴群林,刘中华,徐波,于冬男,戴建强,郄文斌.脑功能区手术唤醒麻醉与清醒程度的研究[J].中国微侵袭神经外科杂志,2005,10(11):497-498. 被引量:27
  • 3王庚,吴新民.瑞芬太尼复合麻醉患者术后急性阿片类药物耐受的发生[J].中华麻醉学杂志,2007,27(5):389-392. 被引量:88
  • 4吴新民,许幸,王俊科,王鲲鹏,薛张纲,缪长虹,邓小明,艾登斌,于浩.静脉注射右美托咪啶辅助全身麻醉的有效性和安全性[J].中华麻醉学杂志,2007,27(9):773-776. 被引量:242
  • 5Piper SN, Rohm KD, Suttner SW, et al. A comparison of nefopam and clonidine for the prevention of postanesthetic shivering:A comparative,double blind and placebocontrolled dose ranging study [J]. Anaesthesia, 2004, 59: 559-64.
  • 6Elvan EG, Oc, B, Uzun S, et al. Dexmedetomidine and postoperative shivering in patients undergoing elective abdominal hysterectomy [J]. Eur J Anaesthesiol, 2008, 25(5): 357-64.
  • 7Biter C, Esmaoglu A, Akin A, et al. Dexmedetomidine and meperidine prevent postanaesthetic shivering [J]. Eur J Anaesthesiol, 2006, 23 (2): 149-53.
  • 8Crossly AWA, Mahajan RP. The intensity of postoperative shivering is unrelated to axillary temperature [J]. Anaesthesia, 1994, 49(3): 205-7.
  • 9Menigaux C, Guignard B, Fletcher D, et al. More epidural than intravenous sufentanil is required to provide comparable postoperative pain relief~J]. Anesth Analg, 2001, 93(2): 472-6.
  • 10Afonso J, Reis F. Dexmedetomidine: current role in anesthesia and intensive care[J]. Rev Bras Anestesiol, 2012, 62(1): 118-33.

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