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右美托咪定辅助颈丛阻滞在30例甲状腺腺瘤手术中的应用

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摘要 目的观察右美托咪定辅助用药对甲状腺腺瘤手术颈丛神经阻滞麻醉效果的影响。方法 60例择期于颈丛神经阻滞麻醉下行甲状腺腺瘤切除手术患者分为观察组和对照组,各组30例。颈丛神经阻滞后5min,观察组静脉泵注右美托咪定(Dex)0.5μg·kg-1·h-1,维持泵注30 min,对照组静脉注射芬太尼1μg/kg+咪达唑仑0.05mg/kg,继以输注生理盐水。记录入室前(T0)、颈丛神经阻滞后5 min即静脉给药即刻(T1)、静脉给药后10 min(T2)、30 min(T3)、50 min(T4)及手术结束(T5)的MAP、HR。并观察镇静、镇痛程度和术中不良反应发生率,术后行VAS评分和Ramsay镇静评分,评估麻醉效果和患者的麻醉满意度。结果 T1时,两组MAP均明显升高(P<0.05);T3~T5时,观察组MAP、HR明显低于对照组,差异有统计学意义(P<0.05),与T0比较对照组MAP、HR明显升高,,差异有统计学意义(P<0.05);与对照组比较T3~T5时观察组VAS评分明显降低,差异有统计学意义(P<0.05),Ramsay镇静评分明显升高,差异有统计学意义(P<0.05)。结论小剂量右美托咪定短时间持续泵注辅助颈丛阻滞与芬太尼复合咪达唑仑静脉注射辅助颈丛神经阻滞比较,镇静、镇痛效果更好,可有效抑制交感神经兴奋症状,且血流动力学稳定,适宜作为甲状腺腺瘤手术颈丛神经阻滞麻醉辅助用药。
作者 刘勇 陈济民
出处 《河南医学高等专科学校学报》 2017年第2期126-128,共3页 Journal of Henan Medical College
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