摘要
【目的】观察右美托咪啶(DEX)在子宫肌瘤高强度聚焦超声(HIFU)治疗术中应用的临床效果。【方法】180例择期行子宫肌瘤HIFU治疗术患者,年龄22~58岁,ASA分级I~II级,随机分为DEX组(D组)和对照组(C组),每组90例。D组于手术前20 min给予DEX负荷剂量0.8μg/kg ,随后以0.2μg/(kg · h)的速率静脉输注至术毕,C组给予等容量0.9%氯化钠溶液。手术开始前及手术中根据OAA/S镇静评分、VAS镇痛评分予静脉注射咪达唑仑、芬太尼,比较两组患者咪达唑仑、芬太尼的用量,呼吸抑制及麻醉满意度(ISAS 评分)情况。【结果】D组与C组分别有59例(65.6%)和90例(100%)需要加用咪达唑仑,用量分别为(1.05±0.52)mg和(3.68±0.96)mg,D组用量少于C组(P <0.05)。所有患者均需追加芬太尼,D组与C组用量分别为(0.13±0.09)m g和(0.18±0.08)m g ,D组用量少于C组( P <0.05)。D组有9例出现心动过缓,C组有4例,D组心动过缓发生率高于C组( P<0.05)。D组高血压、心动过速、呼吸抑制发生率明显低于C组( P <0.05),D组ISAS评分高于C组( P <0.05)。【结论】 DEX在子宫肌瘤患者 HIFU 治疗手术中可以减少咪达唑仑及芬太尼用量,减少呼吸抑制的发生,提高患者麻醉满意度。
[Objective]To observe the clinical efficacy of dexmedetomidine(DEX) in high intensity focused ul-trasound(HIFU) treatment for patients with hysteromyoma .[Methods]Totally 180 ASA Ⅰ ~ Ⅱ patients(aged 22~58 years old) with hysteromyoma scheduled for HIFU treatment were randomly divided into DEX group (group D ,n =90) and control group(group C ,n=90) .Group D was given intravenous infusion of DEX by 0 .2μg/(Kg . h) until the end of operation after a loading dose of 0 .8μg/kg at 20min before operation .Group C was infused with equal volume of 09% normal saline .According to OAA/A sedation score and VAS analgesia score ,midazolam and fentanyl were intravenously injected before and during the operation .The dosage of midazolam and fentanyl ,re-spiratory depression and anesthesia satisfaction (ISAS score) were compared between two groups .[Results] Mid-azolam was required in 58 patients (65 .6% ) in group D and 90 patients (100% ) in group C ,and the dose was (1 .05 ± 0 .52)mg and (3 .68 ± 0 .96)mg ,respectively .The dose of midazolam in group D was lower than that in group C( P 〈0 .05) .All patients additionally required fentanyl ,and the dose was (0 .13 ± 0 .09)mg and (0 .18 ± 0 .08)mg ,respectively .The dose of fentanyl in group D was lower than that in group C ( P 〈 0 .05) .The inci-dence of tachycardia in group D was higher than that in group C ( P 〈0 .05) ,while the incidence of hypertension and respiratory depression in group D was lower that in group C ( P 〈0 .05) .ISAS score in group D was higher than that in group C( P 〈0 .05) .[Conclusion]DEX used in HIFU treatment of patients with hysteromyoma can reduce the dose of midazolam and fentanyl ,decrease the incidence of respiratory depression and increase anesthesia satisfaction of patients .
出处
《医学临床研究》
CAS
2014年第2期293-294,297,共3页
Journal of Clinical Research