右美托咪定行监护麻醉在老年性白内障合并高血压患者眼科手术中的应用

Application of dexmedetomidine monitored anesthesia care in senile patients with hypertension undergoing cataract surgery

目的:观察右美托咪定在老年性白内障合并高血压患者白内障手术中应用效果。方法:选择老年性白内障合并高血压患者40例行择期超声乳化手术,随机分2组,每组20例。观察组为右美托咪定组,对照组为生理盐水组。记录两组患者血压(BP)、心率(HR)、脉搏血氧饱和度(SpO2)、镇静评分以及血管活性药物的应用情况。结果:观察组术中SBP、DBP、HR出现不同程度的下降(P<0.05或P<0.01),但无需纠正;对照组术中SBP、DBP、HR出现不同程度的升高(P<0.05或P<0.01),有7例患者使用血管活性药物;两组患者在吸氧的状态下,SpO2均接近100%;观察组镇静评分高于对照组(P<0.05)。结论:老年性白内障合并高血压患者白内障手术中,应用右美托咪定行监护麻醉,能够达到镇静、镇痛和稳定循环作用。

AIM： To investigate the effects of dexmedetomidine on hemodynamics and sedation in senile patients with hypertension undergoing cataract surgery. METHODS： 40 senile patients with hypertension scheduled undergoing elective phacoemulsification surgery were enrolled and randomly assigned to observation group（dexmedetomidine, n = 20） and control group （normal saline, n=20）. Blood pressure, heart rate and pulse oxygen saturation in both groups were ob served. Sedation score and dosage of vasoactive drugs were recorded. RESULTS： The levels of systolic blood pressure （SBP）, diastolic blood pressure（DBP） and heart rate（HR） in intraoperative were decreased of different degrees （P 〈 0. 05 or P〈0. 01）, but there were no additional vasoactive agents were administered in observa-tion group. Whereas patients in the control group, the levels of SBP, DBP and HR were mcreased （P〈0.05 or P〈0.01）,furthermore 7 patients required vasoconstriction drugs. Two groups of patients in a state of oxygen, pulse oxygen saturation were close to 100 %. In observation group, the level of sedation score was highr than that in control group （P〈0.05）. CONCLUSION. Monitored anesthesia care under dexmedetomidine can provide optimal sedation, appropriate analgesia and stable hemodynamics in senile patients with hypertension undergoing cataract surgery.