不同剂量右美托咪定对焦虑患者情绪及记忆影响的比较

Comparison of the Effects of Different Dose Dexmedetomidine on Emotion and Memory in Patients with Anxiety

目的观察比较不同剂量右美托咪定对焦虑患者情绪及记忆的影响。方法选择ASAⅡ~Ⅲ级且术前焦虑评分>30mm的急诊剖宫产患者60例,随机分为3组,每组20例。待胎儿取出后,分别于15 min内泵注生理盐水(C组)、右美托咪定0.5μg/kg(D0.5组)以及右美托咪定1μg/kg(D1组)。评估各组患者入室、用药前、用药后30 min的焦虑、镇静程度,评价患者记忆情况以及手术结束后4 h的记忆情况。记录并比较3组患者术中的平均压(MAP)、心率(HR)、血氧饱和度(Sp O2)等。结果与C组相比,D0.5组与D1组用药后均有一定程度的镇静作用,焦虑程度均较术前明显减轻(P<0.05),2组均有顺行性遗忘作用(P<0.05),且D1组顺行性遗忘程度明显高于D0.5组(P<0.05)。用药后D0.5组与D1组MAP和HR低于C组(P<0.05)。结论右美托咪定对焦虑患者有明显的镇静、抗焦虑作用,对记忆的影响与剂量有关。

Objective To compare the effects of dexmedetomidine of different dose on both emotion and memory in patients with anxiety. Methods Sixty caesarean patients with anxiety visual analog test （AVAT） 〉30 mm, ASA 11 or m, who were admitted in emergency were randomly divided in three groups （n = 20, each group）. After the baby born, patients were infused intravenously with saline in group C, dexmedetomidine at 0.5 txg/kg in group D0.5, and dexmedetomldine at 1.0 p^g/kg in group D 1 over 15 minutes. AVAT, Rasmay score and memory function were evaluated at preopera- tion, before drug infusion and thirty minutes after drug infusion. Memory function were evaluated again 4 hours after operation. The mean arterial pressure （MAP）, heart rate （HR） and SpO2 of patients during operation were recorded. Results Patients in groups of D0.5 and D 1 had significant seda- tion and decrease in anxiety after drug infusion when compared to preoperation （P 〈 0.05 ）. Compared with group D0.5, D1 has higher anterograde amnesia degree. After drug infusion, the MAP and HR were lower compared with group C （P 〈 0.05 ）. Conclusion Dexmedetomidine is very useful for anxiety and sedation. The antemgrade amnesia depends on the dose of dexmedetomidine.