首页|不同剂量瑞芬太尼联合右美托咪定在老年患者椎体成形术中的麻醉效果及对血流动力学的影响

不同剂量瑞芬太尼联合右美托咪定在老年患者椎体成形术中的麻醉效果及对血流动力学的影响

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目的:探讨不同剂量瑞芬太尼联合右美托咪定在老年患者椎体成形术中的麻醉效果及对血流动力学的影响。方法:选取 2021 年 1 月—2024 年 1 月江阴南闸医院行椎体成形术治疗的 103 例老年患者作为研究对象,根据瑞芬太尼用药剂量不同分为两组,A组(n=51)和B组(n=52),均于术前 15 min静脉泵注 0。3 μg/(kg·h)右美托咪定维持至术毕。术前 5 min,分别给予A组、B组 0。5 μg、1。0 μg/(kg·h)瑞芬太尼静脉泵注。比较两组麻醉前(T0)、套管针插入时(T1)、骨水泥注入时(T2)、皮肤缝合时(T3)、术毕 10 min(T4)时间点血流动力学指标水平,镇痛镇静效果及不良反应发生情况。结果:T0 时间点,两组动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)水平比较,差异无统计学意义(P>0。05);T1~T4 各时间点,两组MAP、HR、SpO2 水平较T0 时间点降低,但B组T1~T4 各时间点MAP、HR、SpO2 水平均高于A组,差异有统计学意义(P<0。05)。T1~T3 时间点,B组RSS评分均高于A组,差异有统计学意义(P<0。05)。术后 1 h、6 h、12 h,B组视觉模拟(VAS)评分均低于A组,差异有统计学意义(P<0。05)。两组不良反应发生率比较,差异无统计学意义(P>0。05)。结论:1。0 μg/(kg·h)瑞芬太尼联合右美托咪定在老年患者椎体成形术中具有良好的镇痛、镇静效果,能有效维持患者血流动力学稳定,且不会增加不良反应发生率,安全性好。
Effects of Different Doses of Remifentanil Combined with Dexmedetomidine on Anesthesia and Hemodynamics in Senile Patients Undergoing Vertebroplasty
Objective:To investigate the effect of different doses of remifentanil combined with dexmedetomidine on anesthesia and hemodynamics in elderly patients undergoing vertebroplasty.Method:A total of 103 elderly patients treated with percutaneous vertebroplasty in Jiangyin Nanzha Hospital from January 2021 to January 2024 were selected as the study objects and divided into two groups according to different doses of remifentanil[group A(n=51)and group B(n=52)].Both groups were injected with 0.3μg/(kg·h)dexmedetomidine by intravenous pump 15 min before surgery and maintained until the end of the operation.5 min before surgery,group A was given 0.5μg/(kg·h)remifentanil intravenously and group B was given 1.0μg/(kg·h)remifentanil intravenously.Hemodynamic indexes,analgesic and sedative effects and adverse reactions were compared between the two groups before anesthesia(T0),during trocar insertion(T1),bone cement injection(T2),skin suture(T3),and 10 min after surgery(T4).Result:At the time point of T0,there was no significant difference in the comparison of mean arterial pressure(MAP),heart rate(HR)and saturation of periphearal oxygen(SpO2)levels between the two groups(P>0.05).The levels of MAP,HR and SpO2 in both groups were lower than those in T0 at each time point from T1 to T4,but the levels of MAP,HR and SpO2 in group B were higher than those in group A at each time point from T1 to T4,with statistical significant differences(P<0.05).From T1 to T3,the RSS scores of group B were higher than those of group A(P<0.05).The visual analogue scales(VAS)scores of group B were lower than those of groupA 1 h,6 h and 12 h after operation,with statistical significant differences(P<0.05).There was no significant difference in comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:1.0μg/(kg·h)remifentanil combined with dexmedetomidine has good analgesic and sedative effects during percutaneous vertebroplasty in elderly patients,and can effectively maintain the hemodynamic stability of patients,without increasing the incidence of adverse reactions,and has good safety.

VertebroplastyRemifentanilDexmedetomidineAnesthetic effectHemodynamics

黄君

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江阴南闸医院 江苏 江阴 214405

椎体成形术 瑞芬太尼 右美托咪定 麻醉效果 血流动力学

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(36)