右美托咪定致呼吸暂停1例并文献回顾

1 case of apnea caused by dexmedetomidine and a review of literature

目的探讨右美托咪定致呼吸暂停1例患者的临床症状。方法回顾性分析1例患者因宫颈上皮内瘤样病变Ⅲ级(CINⅢ)、宫颈人乳头瘤病毒(HPV)感染拟在腰硬联合麻醉下行宫颈锥形切除术,由右美托咪定镇静导致呼吸暂停的临床资料。结果患者术后精神、睡眠良好,各项生命体征均正常,血压(BP)120/78 mm Hg(1 mm Hg=0.133 k Pa),心率(HR)80次/min,呼吸频率(RR)18次/min,血氧饱和度(Sp O2)100%。复查各项检验结果未见明显异常,术后第3天康复出院。结论虽然右美托咪定出现呼吸抑制少见,但是当给予右美托咪定镇静时仍需要严密观察患者是否有呼吸抑制的出现,以便及时处理,避免发生不良后果。

Objective To discuss the clinical symptoms of 1 case of apnea caused by dexmedetomidine. Methods Retrospective analysis was made on clinical data of 1 patient with grade Ⅲ cervical intraepithelial neoplasia（CINⅢ） and human papillomavirus（HPV） of the cervix infection was treated by combined spinal epidural anesthesia and conization of dexmedetomidine. Patients had apnea caused by dexmedetomidine. Results After operation, patients had a good spirit and good sleep, and all the physical signs were normal, with blood pressure（BP） as 120/78 mm Hg（1 mm Hg=0.133 k Pa）, heart rate（HR） as 80 times/min, respiratory rate（RR） as 18 times/min and blood oxygen saturation（Sp O2） as 100%. Conclusion Although respiratory inhibition is rare caused by dexmedetomidine, close observation still should be payed to whether the patient has respiratory depression when dexmedetomidine for sedation, so as to deal with it in time and avoid adverse consequences.