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右美托咪啶在颈神经丛阻滞甲状腺切除术中镇静效果观察

高斌1,陈学军2,3,李德强1,2,纪洪波4,张守林5,高顺利2,3,彭秋萍1,2   

  1. 1. 天津医科大学宝坻临床学院
    2.
    3. 宝坻区人民医院
    4. 天津宝坻区人民医院麻醉科
    5. 宝坻区医院麻醉科
  • 收稿日期:2010-11-25 修回日期:2011-06-02 出版日期:2011-10-15 发布日期:2011-10-15
  • 通讯作者: 高斌

  • Received:2010-11-25 Revised:2011-06-02 Published:2011-10-15 Online:2011-10-15
  • Contact: Bin GAO

摘要: 摘要 目的:探讨右美托咪啶(Dex) 在颈神经丛阻滞甲状腺手术中的镇静作用。方法:行单侧甲状腺腺叶手术患者60例随机分Dex(D)组和生理盐水(NS ,N)组,在颈神经丛阻滞前,D组30例持续静脉泵入Dex,N组30例持续静脉泵入NS,2 组负荷量、维持量和停药时间相同。记录患者阻滞前10min(T0)、阻滞后5(T1)、10 (T2)、15( T3)、30 (T4) min及分离甲状腺上极(T5)的收缩压(SP)、舒张压(DP)、心率(HR)、镇静评分(Ramsay)、脑电双频指数(BIS)。结果:D组干预因素对SP、DP、HR、Ramsay及BIS水平的影响差异有统计学意义,测定时点与分组存在交互作用,不同时间之间SP、DP、HR、Ramsay及BIS水平具有显著差异。结论:在颈神经丛阻滞下甲状腺手术中,应用Dex可产生镇静、稳定BP、HR的作用。

关键词: 颈神经丛 神经阻滞 甲状腺 手术, 右美托咪啶

Abstract: Effects of Sedation of Dexmedetomidine in Cervical Plexus Block for Thyroid Surgery GAO bin,CHEN xuejun,LI deqiang,JI hongbo,ZHANG shoulin,GAO shunli,PENG qiuping,TIAN yingjie Baodi Clinical college of Tianjin Medical University , Tianjin301800,China Abstract Objective:To investigate the effect of sedation of dexmedetomidine (Dexmedetomidine, Dex) in cervical plexus block for thyroid surgery.Methods:Sixty patients performed unilateral thyroid gland surgery ,were divided into tow groups randomly ,group Dex (D) and group NS (N), group D 30 cases continuous intravenous infusion of Dex, group N 30 cases continuous intravenous infusion of NS before cervical plexus block。The same of loading dose 、maintain dose and time of withdrawal amount two groups. SP、DP、HR、SpO2、Ramsay、BIS were recorded after patient in the operating room at times :10mins before nerve block (T0) ,after blocked 5 (T1), 10 (T2), 15 (T3), 30 (T4) min and the time of separating the upper pole of thyroid (T5) .Results: The level of SP, DP, HR were significantly increased every times in group N, change nosignificantly in group D.in each group compared with T0((P>0.05); group D compared with N ( P < 0.01). SpO2 were not changes in two groups. BIS and Ramsay were significantly different at T0 compared with T1, T2, T3, T4, T5 in group D (P<0.01). BIS gradually decreased compared with Group D after the block 10min. Conclusion:good effect of Sedation 、BP and HR were stable in the thyroid gland surgery under the cervical plexus nerve block coadministed with Dex. Key words cervical plexus nerve block thyroid surgery dexmedetomidine