| 摘要: |
| ［摘要］目的 评估右美托咪定与咪达唑仑用于老年患者局麻下疝修补术中的可行性和有效性．方法 选择ASAⅠ～Ⅱ级择期局麻下行疝修补术的老年患者60例，年龄≥65岁，随机分为右美托咪定组（D组）和咪达唑仑组（M组），每组患者30例．D组在10 min静脉注射1 μg/kg负荷剂量的右美托咪定，随后以0.4 μg/（kg·h）速度泵注．M组10 min内静脉注射0.06 mg/kg的咪达唑仑，10 min内泵完，之后以0.04 mg/（kg·h）维持至手术结束．观察并比较给药前（T0）、切皮时（T1）、手术开始15 min（T2）、手术开始30min（T3）、缝皮完毕（T4）各个时点心率（HR）、平均动脉压（MAP）以及不良反应发生情况．结果 2组镇静评分差异无统计学意义（P＞0.05）；与T0时点比较，T1～T4时点D组HR明显减慢，且D组明显慢于M组（P＜0.05）；与D组比较，M组的呼吸抑制、烦躁发生率升高，而心动过缓发生率明显降低．结论 右美托咪定在老年患者局麻下疝修补术中可以达到和咪达唑仑一样满意的镇静效果，对呼吸影响甚微，术中烦躁发生率低，但有减慢心率的作用． |
| 关键词: ［关键词］右美托咪定 咪达唑仑 疝修补术 |
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| 基金项目:［基金项目］云南省教育厅科学研究基金资助项目（2010Z030） |
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| Application of Dexmedetomidine and Midazolam in Herniorrhaphy Surgery for Older Patients |
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QU Qi-cai
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（Dept.of Anesthesiology，The 2nd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101，China ）
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| Abstract: |
| ［Abstract］Objective To compare the feasibility and efficacy between dexmedetomidine and midazolam in herniorrhaphy surgery for older patients. Methods Sixty American Society of Anesthesiology（ASA）grade Ⅰ～Ⅱpatients， treated by herniorrhaphy surgery under local anesthesia，were randomly divided into dexmedetomidine group（n＝30） and midazolam group（n＝30）.Patients in dexmedetomidine group were given dexmedetomidine at a loading dose of 1μg/kg for 10 min，then they were injected continuously by 0.4 μg/(kg·h)，whereas midazolam group were given midazolam at a loading dose of 0.06 mg/kg， then 0.04 mg/(kg·h) injected continuously.The mean blood pressure（MAP）and heart rate（HR） were recorded before infusion（T0），incision of skin（T1），15min（T2）and 30 min（T3） after administration and when sutured skin （T4），adverse reaction were also assessed. Results The difference of sedation level was not significant between the two groups（P＞0.05）.Compared with T0 ，the decrease of HR was significantly more in dexmedetomidine group from T1 to T4（P＜0.05）. Compared with midazolam group ， the decrease of HR was significantly more in dexmedetomidine group from T1 to T4（P＜0.05）. Compared with dexmedetomidine group，the rate of respiratory depression and restlessness were more in midazolam group，but bradycardia was lower（P＜0.05）.Conclusions Dexmedetomidine is a comparable alternative to midazolam for sedation in herniorrhaphy surgery under local anesthesia. It is associated with better respiration and lower restlessness but with a high incidence of bradycardia. |
| Key words: ［Key words］Dexmedetomidine Midazolam Herniorrhaphy |