右美托咪定在老年前列腺汽化术中的临床效果分析

Analysis on clinical effects of dexmedetomidine in the treatment for elderly prostatevaporization

目的探讨右美托咪定在老年前列腺汽化术中的麻醉效果。方法200例前列腺汽化术患者随机分为A组和B组，两组病例均采用腰醉-硬膜外联合麻醉。A组输注右美托咪定，手术开始前10min按0．5μg／kg剂量输注右美托咪定，之后以0．5μg／kg／h维持；B组静脉输注生理盐水。分别记录两组麻醉前（T0）、麻醉后（T1）及用药后5min（T2）、30min（T3）、60min（T4）MBP、HR、RR和SpO2，并进行Ramsay评分。结果T0时两组病例中MBP、HR、RR以及Ramsay评分无统计学差异，A组病历T2时MBP为（98±8）mmHg、HR为（84±9）次／分，均低于Tn时的（106±7）mmHg及（88±12）次／分（P〈0．05），而Ramsay评分T2时为（3．1±0．4）分高于T2时的（2．0土0．1）分（P〈0．05）T2-T4时B组MBP、HR、Ramsay评分均低于A组（P〈0．05），T1-T4时两组RR、SpO2无统计学差异。结论右美托咪定复合腰醉一硬膜外联合麻醉在老年前列腺汽化术中的麻醉效果满意，能产生良好的镇静效果，值得临床推广。

[Abstract] Objective To explore the anesthetic effect of dexmedetomidine in the treatment for prostate vaporization. Methods 200 cases of prostate vaporization were randomly divided into group A and group B, two groups were treated with waist drunk-epidural anesthesia. Group A received infusion right prop microphone given 10 mins before the start of the surgery 0.5 μ g/kg dose infusion of the right prop microphone set, then to 0.5 μL g/kg/h maintain; group B received intravenous infusion of normal saline. Recording before anesthesia （T0）, after anesthesia （T 1） and after treatment 5 min （T2）, 30 min （T3）, 60 min （T4）, MBP, HR, RR and SpO2 of the two groups, and scoring Ramsay. Results There was no significant difference between two groups in MBP, the HR, RR and Ramsay score at T0. Group A of medical T2 when the MBP （98 ± 8） mmHg, HR（84± 9） beats/min, were lower than those at TO （106 ± 7） mmHg （88± 12） times/min （P〈 0.05）, Ramsay score T2 for （3.1± 0.4） points higher than To （2.0± 0.1） （P〈 0.05）.Group B was lower than group A in MBP, HR, Ramsay score from T2 to T4 （P〈 0.05）.There was no significant difference between two groups in RR and SpO2 from T1 to T4. Conclusion The effects of dexmedetomidine joint with waist drunk-epidural anesthesia in the treatment for elderly prostate vaporization are satisfactory, it can produce a good sedative effect and is worthy of clinical promotion.