右旋美托咪啶预先给药对全麻前上导尿管时不适感的影响-现代医学

右旋美托咪啶预先给药对全麻前上导尿管时不适感的影响

单位：武汉大学人民医院

分类号：

出版年·卷·期（页码）：2012·40·第四期（390-392）

摘要：

【摘要】目的：观察右旋美托咪啶负荷剂量预先给药对全麻前导尿病人不适感的影响。方法：选择40例拟行全麻颅脑手术患者（动脉瘤患者除外），随即分为四组，对照组(S)，右旋美托咪啶组(D)，利多卡因凝胶组(L)，咪达唑仑组(M)。进入手术室连接心电监护后，D组患者用微量泵泵注右旋美托咪啶，负荷量0.4µg/kg，10min后开始给患者上导尿管，S组患者泵注生理盐水，L组上导尿管之前，导尿管上均匀涂抹利多卡因凝胶，M组上尿管前10min静脉给予咪达唑仑0.05mg/kg，记录给药前(T1)，给药10min后上尿管前(T2)，上尿管后(T3)，上尿管后10min(T4)，患者心率(HR)，平均动脉压(MAP)的变化以及VAS疼痛评分。结果：D组，L组，M组与S组相比，T1，T2时间点患者HR，MAP，T4时间点HR无统计学意义(P>0.05），M组与S组相比，T4时间点MAP无统计学意义(P>0.05），D组，M组与S组相比，T3时间点HR，MAP，有统计学意义(P<0.05），D组与M组相比，T3时间点HR，MAP，有统计学意义(P<0.05），D组与S组相比，T4时间点MAP有统计学意义(P<0.05），L组与M组相比，T3时间点HR有统计学意义(P<0.05），D组VAS疼痛评分明显低于S组，L组和M组。结论：麻醉前导尿结合负荷剂量右旋美托咪啶预给药是缓解导尿时患者不适感的有效方法,对循环干扰较小。

【Abstract】Objective: To evaluate the effect of dexmedetomidine premedication on patients with urinary catheter before general anesthesia. Methods: 40 patients who were going to craniocerebral surgery （exclude aneurysm patient）, divided into 4 groups, group S, group D, group L, group M. electrocardio-custody the patients, group D were given Dex 0.4µg/kg in 10min by micro-pump, then urethral catheterication, group S were given saline 10min by micro-pump, group L were urethral catheterication after lidocaine gelatin, group M were urethral catheterication after given midazolam 0.05mg/kg 10 min by intravenous. To recorded several indicators such as HR, MAP, VAS in 4 periods: before given Dex (T1), after given 0.4ug/kg(T2), after urethral catheterication(T3), 10min later(T4). Results: Compared with group S, group D, group L and group M had no statistic significance in HR, MAP in T1, T2, in HR in T4 (P>0.05), Compared with group S, group M had no statistic significance in MAP in T4 (P>0.05), Compared with group S, group D and group M had statistic significance in HR, MAP in T3 (P<0.05), Compared with group M, group D had statistic significance in HR, MAP in T3 (P<0.05), Compared with group S, group D had statistic significance in MAP in T4 (P<0.05), Compared with group M, group L had statistic significance in HR, MAP in T3 (P<0.05),VAS in group D is much lower than group S and group M.Conclusions: Dexmedetomidine premedication on patients with urinary catheter before general anesthesia is an effectiveway to relief the severity of discomfort．There lower interferences on circulation.

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