右美托咪定用于高血压病患者腰硬联合麻醉的镇静效果及对血流动力学的影响

Efficacy of Dexmedetomidine on Combined Spinal and Epidural Analgesia in Patients with Hypertension and Effects on Haemodynamics

目的:探讨右美托咪定用于高血压病患者腰硬联合麻醉的镇静效果及对血流动力学的影响。方法:选取2014年10月—2016年5月汉川市人民医院收治的拟行腰硬联合麻醉的高血压病患者100例作为研究对象,以随机数字表法分为观察组和对照组,每组50例。观察组患者给予右美托咪定进行辅助麻醉,对照组患者未给予右美托咪定。于麻醉前(T_0)、蛛网膜下腔给药后30 min(T_1)和右美托咪定给药15 min(T_2)、30 min(T_3)、60 min(T_4)时观察两组患者心律、平均动脉压的变化情况,比较两组患者的Ramsay镇静评分。结果:T_2—T_4时,观察组患者的心率明显低于T_0时,差异有统计学意义(P<0.05);对照组患者各个时间点心率的差异均无统计学意义(P>0.05)。T_2—T_4时,两组患者的平均动脉压均较T_0时显著降低,且观察组降低幅度显著高于对照组,差异均有统计学意义(P<0.05)。术后15~60 min,观察组患者Ramsay镇静评分显著优于对照组,差异有统计学意义(P<0.05)。结论:右美托咪定对高血压病患者腰硬联合麻醉的镇静效果较好,对患者心率和血流动力学的影响较小。

OBJECTIVE： To probe into the efficacy of dexmedetomidine on combined spinal and epidural analgesia in patients with hypertension and effects on haemodynamics. METHODS： 100 hypertension patients with combined spinal and epidural analgesia admitted into Huanchuan Prople＇s Hospital from Oct. 2014 to May 2016 were extracted to be divided into observation group and control group via the random number table,with 50 cases in each. The observation group were given dexmedetomidine as supplemental anesthesia,while the control group were not. Changes of heart rhythm,mean arterial pressure of two groups were observed before anesthesia（ T_0）,at 30 min after subarachnoid dosing（ T_1）,and at 15 min（ T_2）,30 min（ T_3）,60 min（ T_4） after dexmedetomidine delivery,the Ramsay sedation score of two groups were compared. RESULTS： The heart rate of T_2-T_4 in observation group was significantly lower than that of T_0,with statistically significant difference（ P〈0. 05）. There was no statistical significance between two groups in the heart rate at different time points（ P〈0. 05）. Compared with T_0,the mean arterial pressure of two groups at T_2-T_4 decreased significantly,and the observation group was significantly better than the control group,with statistically significant difference（ P〈0. 05）. After surgery of 15 min-60 min,the Ramsay sedation score of observation group was significantly better than that of control group,with statistically significant difference（ P〈0. 05）. CONCLUSIONS： The sedation effects of dexmedetomidine on combined spinal and epidural analgesia in patients with hypertension is significant and had few effects on the heart rate and haemodynamics.