右美托咪定在局部麻醉乳突根治术中的临床应用

Clinical Application of Dexmedetomidine as an Adjunct to Local Anesthesia in Radical Mastoidectomy

目的:研究右美托咪定辅助局麻在乳突根治术中的镇静效果。方法:选择80例欲行乳突根治术的患者,随机分为对照组(C组)和右美托咪定组(D组),每组各40例,D组给予右美托咪定0.5μg/kg负荷量10min输注完毕,继以0.5μg/(kg·h)泵注维持至术毕,C组给予等容量生理盐水。观察并记录两组患者给药前(T0)、给药10min时(T1)、给药60min(T2)和术毕时(T3)的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SPO2)和OAA/S评分,观察有无呼吸抑制等不良反应的发生。结果:与C组相比,D组患者HR、MAP、OAA/S评分在T1-T3时点明显低于C组患者,差异有显著性(P<0.05)。两组患者给药前后SPO2比较,差异均无显著性。结论:右美托咪定辅助局部麻醉下乳突根治术镇静效果良好,无呼吸抑制,血流动力学稳定,故可用于局部麻醉下乳突根治术患者的术中镇静。

Objective： To evaluate the sedative effect of intravenous dexmedetomidine as an adjunct to local anesthesia in radical mastoidectomy. Methods： Eighty patients of ASA I - H who underwent selective operation of radical mastoideetomy under local anesthesia were randomly assigned to control group （group C） and dexmedetomidine group （group D）. Changes of heart rate （HR）, mean arterial pressure （MAP）, satiation of oxygen （SP02） and the Observer＇s Assessment of Alertness/Sedation scale （OAA/S） were measured before anesthesia （T0）, after injection at 10 min（T1）, 60 min （T2） and at the end of operation （T3）. Results： HR, MAP, and OAA/S score were decreased in group D and the decrease of these indices was much more significant in group D than in group C（P〈0.05）. There was no significant change in SPOz between the two groups dur- ing the operation. Conclusion： Dexmedetomidine can achieve satisfying sedative effect and display a stable hemodynamic state without respiratory inhibition. It can be used for sedation in radicalmastoidectomy under local anesthesia.