摘要
目的观察右美托咪定用于局麻经皮椎体后凸成形术(PKP)中的镇痛效果和对血流动力学的影响。方法择期行PKP手术老年患者80例,年龄61~82岁,随机均分为两组。D组于手术开始前持续泵注右美托咪定负荷剂量1.0μg/kg,10min泵完,后以0.5μg·kg-1·h-1维持至手术结束。C组泵注等量生理盐水。两组均用1.0%的利多卡因局部浸润麻醉,总量为30~40ml。观察患者给药后即刻(T0)、注入局麻药时(T1)、穿刺针到达椎体时(T2)、骨水泥注入时(T3)、手术结束时(T4)的MAP、HR和疼痛VAS评分。结果与C组比较,T1~T4时D组VAS评分、MAP明显降低(P<0.05),HR明显减慢(P<0.05)。与T0时比较,T1~T4时D组MAP明显降低,HR明显减慢(P<0.05);而C组MAP明显升高,HR明显增快(P<0.05)。结论右美托咪定清醒镇痛可为PKP提供较为满意的镇痛效果,降低围术期血流动力学反应。
Objective To observe the analgesic effect of dexmedetornidine and its influence on hemodynamics in patients undergoing percutaneous kyphoplasty (PKP) surgery. Methods Eighty patients undergoing PKP surgeries aged 61-82 years were randomly divided into dexmedetomidine group (group D) and the control group (group C) for 40 cases each. Group D received loading dose of intravenous infusion of dexmedetomidine 1.0 ~g/kg for 10 min, and then maintained at 0.5μg.kg-1. h-1. Group C received equivalent volume of saline. The MAP and HR were recorded at administration of immediate (To), injection of local anesthetics(Tx ), a puncture needle to vertebral body (T2), bone cement injection (T3),the end of operation (T4),the VAS scores were assessed at T0-T4. Results Patients in the group D had lower VAS scores than those of the group C at T1-T4. At T1-T4, MAP in group D decreased significantly, HR decreased significantly (P〈0. 05) ;MAP in group C increased obviously, HR increased obviously (P〈0. 05). Conclusion Dexmedetomidine can provide effective analgesia for patients undergoing PKP surgery reduce the perioperative hemodynamic response during operation.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第4期353-355,共3页
Journal of Clinical Anesthesiology