右美托咪定在经尿道前列腺电切术患者中的应用观察

The clinic study of dexmedetomidine in patient undergoing the operation of transurethral resection of the prostate

目的观察右美托咪定在经尿道前列腺电切术患者麻醉中的镇静镇痛作用。方法选择ASA分级为Ⅰ～Ⅱ级的患者60例,随机分为实验组(D组)和对照组(S组),各30例,两组电切开始后均给予10%氯化钠持续泵注,D组给予右美托咪定(艾贝宁2ml,0.2mg,江苏恒瑞医药股份有限公司)以1μg/(kg.h)泵注10min后,以0.3～0.6μg/(kg.h)术中维持,S组以同等速度和剂量泵注生理盐水。观察记录两组患者在麻醉前(T0),给药后10min(T1),30min(T2),60min(T3)至手术结束时(T4)的平均动脉压,心率,血氧饱和度,镇静程度和10%氯化钠输注痛的疼痛发生率。结果①D组患者在T1～T4的MAP,HR均明显低于S组(P<0.05);②D组患者的Ramsay镇静评分及高渗氯化钠输注痛在T1～T4也明显低于S组(P<0.01)。结论右美托咪定能有效镇静且不影响呼吸并减轻输注痛的发生率。

Objective To observe the sedative and analgesic effect of the dexmedetomidine in patients undergoing the operation of transurethral resection of the prostate.Methods 60 patients in ASA I^II level were randomly divided into dexmedetomidine group and controlled group.Both of the two groups were received the intravenous 10% sodium chloride at the beginning of the operation.meanwhile,the group D was to inject the dexmedetomidine by 1μg/（kg·h） with mini-pump for ten minutes,then to inject by 0.3~0.6μg/（kg·h）consistently,the group S was to inject the normal saline with the same dose and rate.Before the anesthsia,at 10、30、60 minute after using dexmedetomidine and at the end of the operation,MAP、 HR 、SpO2 scores were observed and recorded respectively.Also to observe and record the sedative scale scores and the pain rate of intravenous 10% sodium chloride consistently.Results ① The scores of MAP,HR at T1~T4 in group D were significantly lower than the group S（P〈0.05）;② The ramsay sedation scale scores and the pain rate of intravenous 10% sodium chloride at T1-T4 in group D was obviously lower than group S（P〈0.01）.Conclusion Dexmedetomidine can efficiently sedate and decrease the injection pain incidence rate without respiratory depression.