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低剂量静脉注射右美托咪定对高压布比卡因脊髓麻醉特性的影响。

Effect of supplementation of low dose intravenous dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine.

作者信息

Harsoor Ss, Rani D Devika, Yalamuru Bhavana, Sudheesh K, Nethra Ss

机构信息

Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.

出版信息

Indian J Anaesth. 2013 May;57(3):265-9. doi: 10.4103/0019-5049.115616.

Abstract

AIMS

Intravenous (IV) dexmedetomidine with excellent sedative properties has been shown to reduce analgesic requirements during general anaesthesia. A study was conducted to assess the effects of IV dexmedetomidine on sensory, motor, haemodynamic parameters and sedation during subarachnoid block (SAB).

METHODS

A total of 50 patients undergoing infraumbilical and lower limb surgeries under SAB were selected. Group D received IV dexmedetomidine 0.5 mcg/kg bolus over 10 min prior to SAB, followed by an infusion of 0.5 mcg/kg/h for the duration of the surgery. Group C received similar volume of normal saline infusion. Time for the onset of sensory and motor blockade, cephalad level of analgesia and duration of analgesia were noted. Sedation scores using Ramsay Sedation Score (RSS) and haemodynamic parameters were assessed.

RESULTS

Demographic parameters, duration and type of surgery were comparable. Onset of sensory block was 66±44.14 s in Group D compared with 129.6±102.4 s in Group C. The time for two segment regression was 111.52±30.9 min in Group D and 53.6±18.22 min in Group C and duration of analgesia was 222.8±123.4 min in Group D and 138.36±21.62 min in Group C. The duration of motor blockade was prolonged in Group D compared with Group C. There was clinically and statistically significant decrease in heart rate and blood pressures in Group D. The mean intraoperative RSS was higher in Group D.

CONCLUSION

Administration of IV dexmedetomidine during SAB hastens the onset of sensory block and prolongs the duration of sensory and motor block with satisfactory arousable sedation.

摘要

目的

静脉注射右美托咪定具有出色的镇静特性,已被证明可减少全身麻醉期间的镇痛需求。本研究旨在评估静脉注射右美托咪定对蛛网膜下腔阻滞(SAB)期间感觉、运动、血流动力学参数及镇静的影响。

方法

共选取50例接受SAB下脐下及下肢手术的患者。D组在SAB前10分钟静脉注射右美托咪定0.5微克/千克,推注时间为10分钟,随后在手术期间以0.5微克/千克/小时的速度持续输注。C组输注等量的生理盐水。记录感觉和运动阻滞起效时间、镇痛平面头端高度及镇痛持续时间。采用Ramsay镇静评分(RSS)评估镇静评分,并评估血流动力学参数。

结果

人口统计学参数、手术持续时间和类型具有可比性。D组感觉阻滞起效时间为66±44.14秒,而C组为129.6±102.4秒。D组两个节段消退时间为111.52±30.9分钟,C组为53.6±18.22分钟;D组镇痛持续时间为222.8±123.4分钟,C组为138.36±21.62分钟。与C组相比,D组运动阻滞持续时间延长。D组心率和血压在临床和统计学上均有显著下降。D组术中平均RSS更高。

结论

在SAB期间静脉注射右美托咪定可加速感觉阻滞起效,延长感觉和运动阻滞持续时间,并伴有令人满意的可唤醒镇静效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8400/3748681/c265b15da222/IJA-57-265-g003.jpg

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