引用本文:[点击复制]
[点击复制]
【打印本页】 【在线阅读全文】【下载PDF全文】 查看/发表评论下载PDF阅读器关闭

←前一篇|后一篇→

过刊浏览    高级检索

本文已被:浏览 94次   下载 24 本文二维码信息
码上扫一扫!
右美托咪定对剖宫产围手术期血流动力学及术后神经功能障碍的影响
丁慧,宋文英,宋宇龙,赵静,杨瑞
0
(陕西省人民医院麻醉科)
摘要:
【摘要】 目的 分析右美托咪定对剖宫产围手术期血流动力学及术后神经功能障碍的影响。方法 选取本院收治的72例择期硬膜外麻醉剖宫产患者进行研究,分为研究组与对照组,每组各36例。回顾性分析两组的临床资料,比较两组手术中的血流动力学指标及感觉阻滞情况,同时评估两组麻醉后的Ramsay镇静评分和术中牵拉反应程度,观察记录两组不同时间点(入手术室前记为T0,手术开始即刻记为T1,硬膜外注药完毕后10min记为T2,手术结束即刻记为T3),MMSE评分及术后不良反应的发生情况。结果 研究组T1、T2、T3 HR、DBP、SBP水平均低于T0,差异无统计学意义(P>005);对照组T1、T2、T3 HR、DBP、SBP水平均高于T0(P<005);研究组T1、T2、T3 HR、DBP、SBP水平均低于对照组(P<005)。与对照组比较,研究组麻醉起效时间、达峰效应时间缩短,麻醉平面持续时间均延长(P<005)。术后第1天,研究组MMSE评分高于对照组(P<005);术后第3天,研究组MMSE评分高于对照组(P<005)。研究组心动过缓、呼吸抑制、寒战及恶心呕吐的发生率低于对照组(P<005),两组低血压的发生率比较差异无统计学意义(P>005)。结论 剖宫产围术期应用右美托咪定可缩短硬膜外麻醉的起效时间,延长感觉阻滞时间,有效增强剖宫产术中镇痛、镇静效果,能保持产妇血流动力学的稳定,减少术后不良反应发生率,且不会影响术后认知功能,同时右美托咪啶毒副作用小,安全性较高。
关键词:  右美托咪啶  剖宫产  围术期  血流动力学  术后神经功能障碍
DOI:
基金项目:陕西省自然科学基础研究计划项目(2014JQ2 8055,2016JM8046)
Effect of dexmedetomidine medetomidine on perioperative hemodynamics and postoperative neurological dysfunction in cesarean section
DING Hui,SONG Wenying,SONG Yulong,ZHAO Jing,YANG Rui
(Department of Anesthesiology, Shanxi Provincial People's Hospital)
Abstract:
【Abstract】 Objective To investigate the effect of dexmedetomidine medetomidine on perioperative hemodynamics and postoperative neurological dysfunction in cesarean section. Methods 72 patients undergoing cesarean section under epidural anesthesia were selected and divided into study group and the control group, according to the random number table method. Dexmedetomidine was infused 10 min before anesthesia induction in study group. The control group received the equal volume of 09%NaCl. The clinical data of the two groups were retrospectively analyzed. The hemodynamics and sensory block scope of the two groups were compared. Ramsay sedation scores intraoperative traction reaction were assessed, then the MMSE scores and postoperative adverse reactions at different time points in the two groups were observed and recorded. Results The HR, DBP, and SBP levels in the study group at T1T3 were lower than those at T0, with no significant difference (P>005). While the HR, DBP, and SBP levels in the control group at T1T3 were higher than those at T0 (P<005). The average HR, DBP, and SBP levels in the study group at T1, T2, and T3 were significantly lower than those in the control group (P<005). Compared with the control group, the onset time and time to reach the maximum epidural block were significantly shortened, and the time of sensory block was prolonged in study group (P<005). Apger score between the two groups at 1 and 5 min after birth had no significant difference (P>005). The MMSE scores of the study group was significantly higher than that of the control group at the postoperative 1d and 3d (P<005). The incidence of bradycardia, respiratory depression, chills and nausea and vomiting in the study group was significantly lower than that in the control group (P<005), no difference was found in the incidence rate of the hypotension (P>005). Conclusion The application of the dexmedetomidine during the cesarean section is an effective and safe way to shorten the onset time of epidural anesthesia, prolong the time of sensory block, enhance the analgesic and sedative effects, maintain the stability of the hemodynamics arel, reduce the incidence of adverse reactions with less side effects, which has no influence on the postoperative cognitive function and newborns.
Key words:  Dexmedetomidine  Cesarean section  Perioperative period  Hemodynamics  Postoperative neurological dysfunction

用微信扫一扫

用微信扫一扫