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右美托咪定用于眼科玻璃体手术镇静效果观察
Effect Observation of Intraoperative Sedation with Dexmedetomidine Infusion in Vitreous Body Surgery
  
DOI:
中文关键词:  右美托咪定  咪达唑仑  麻醉深度指数  镇静
英文关键词:Dexmedetomidine  Midazolam  Cerebral state index  Sedation
基金项目:
作者单位
张永洪 李建桥 李娟 绵阳市中心医院麻醉科 四川绵阳 621000 
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中文摘要:
      摘 要 目的:在麻醉深度指数(CSI)指导下,评价眼科玻璃体手术中右美托咪定镇静的有效性和安全性。方法:采用前瞻性随机双盲对照试验方法,60例择期行玻璃体手术患者随机分为右美托咪定组(D组,右美托咪定以0.25 μg·kg-1·h-1输注)和咪达唑仑组(M组,咪达唑仑以25 μg·kg-1·h-1输注)。患者入手术室后行常规麻醉监测和CSI监测,术中CSI靶目标值设定为>80。术中根据CSI值调整药物输注速率。记录术中循环、呼吸参数,术后对患者行镇痛评分、记录不良反应、评估患者和手术医生满意度。结果:D组患者手术开始35~50 min和术毕心率均低于M组(P<0.05),疼痛评分显著低于M组(P<0.05);两组患者其他血流动力学和呼吸参数、手术满意度和药品不良反应发生率比较,差异无统计学意义(P>0.05)。 结论:右美托咪定在玻璃体手术中可降低心率,镇痛起效快,且不良反应小,适于该类手术镇静。
英文摘要:
      ABSTRACT Objective:To assess the efficacy and safety of dexmedetomidine for sedation during vitreous body surgery monitored by the cerebral state index (CSI) . Methods:60 patients who were electively undergoing vitreous body surgery were enrolled in the double blind study, given 0.25 μg·kg-1·h-1 dexmedetomidine (Group D) and 25 μg·kg-1·h-1 midazolam (Group M) at random. They were monitored by the CIS and routine anesthetic care. The target CIS level was set as >80. Drug dose was adjusted according to the CIS level. Changes in circulation and respiratory were noted. Pain were evaluated in the postoperative period using visual analogue scale and adverse drug reaction was recorded. Satisfaction levels of the patients and surgeon were assessed. Results:In Group D, heart rate decreased in the beginning of operation (35 50 min) and postoperative period than group M (P<0.05). Pain scores were lower than group M(P<0.05). There were no significant differences in hemodynamics changes, respiratory parameter, satisfaction of the surgery and adverse effects in both groups(P>0.05). Conclusion:Dexmedetomidine infusion mildly decreased heart rate in the surgery and pain relief worked quickly.It had minor adverse reaction and was appropriate for sedation in this type of surgery.
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