地佐辛联合瑞芬太尼用于阿尔茨海默病患者白内障超声乳化摘除术镇静镇痛的疗效观察
Effect of the dezocine combined with remifentanil in the sedation and analgesia of Alzheimer's disease patients treated with phacoemulsification
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摘要: 目的:探讨地佐辛联合瑞芬太尼用于阿尔茨海默病患者白内障超声乳化摘除术镇静镇痛的临床疗效。方法:选择行眼科白内障超声乳化摘除术的阿尔茨海默病患者60例,ASAⅠ~Ⅱ级,随机分为地佐辛组(D组)和对照组(R组)各30例。D组静脉滴注瑞芬太尼负荷剂量0.25μg·kg-1·min-1持续2 min,随后调为0.08μg·kg-1·min-1维持,同时静脉注射地佐辛0.04 mg/kg+咪达唑仑0.02~0.06 mg/kg;R组静脉滴注瑞芬太尼负荷剂量0.25μg·kg-1·min-1持续2 min,随后调为0.08μg·kg-1·min-1维持,同时静脉注射咪达唑仑0.02~0.06 mg/kg,根据改良警觉/镇静评分调节咪达唑仑用量及术中瑞芬太尼维持量,保持该评分≤2分,手术结束时停止药物输注。于麻醉诱导前、麻醉诱导后、手术开始时和手术结束时记录患者的平均动脉压、心率、呼吸、血氧饱和度、手术持续时间、患者苏醒时间、瑞芬太尼和咪达唑仑的用量及术中不良反应出现的情况。结果:与R组相比,D组诱导后血氧饱和度及呼吸频率的变化均较小(P<0.05~P<0.01),手术时间与麻醉苏醒时间均明显缩短(P<0.01),咪达唑仑及瑞芬太尼总量均显著减少(P<0.01),呼吸抑制发生率低(P<0.05)。结论:地佐辛联合瑞芬太尼微泵输注用于阿尔茨海默病患者行眼科白内障超声乳化摘除术镇静、镇痛效果确切,是一种安全、有效的麻醉方法。Abstract: Objective:To observe the clinical efficacy of dezocine combined with remifentanil in the sedation and analgesia of Alzheimer's disease patients treated with phacoemulsification.Methods:Sixty Alzheimer's disease patients with grade ASA Ⅰ to Ⅱ treated with phacoemulsification were randomly divided into the dezocine group(30 cases, group D) and control group(30 cases, group R).The group D were treated with 0.25μg·kg-1·min-1 of remifentanil for 2 min by vein, then the dosage of remifentanil was adjusted for 0.08μg·kg-1·min-1, and the patients were additionally injected using 0.04 mg/kg of dezocine combined with 0.02 to 0.06 mg/kg of midazolam by vein.The group R were treated with 0.25μg·kg-1·min-1 of remifentanil for 2 min by wein, then the dosage of remifentanil was adjusted for 0.08μg·kg-1·min-1, and the patients were additionally injected using 0.02 to 0.06 mg/kg of midazolam by vein.The midazolam dosage and intraoperative remifentanil dosage were adjusted to maintain the modified observer assessment of sedation ≤2, which was stopped until the end of operation.The mean arterial pressure, heart rate, respiratory rate, oxyhemoglobin saturation, time of operation duration and patients awakening, dosage of remifentanil and midazolam and intraoperative adverse reaction were recorded before anaesthesia, after anesthesia, at the start of operation and at the end of operation.Results:Compared with the group R, the changes of oxyhemoglobin saturation and respiratory frequency in group D were less after anesthesia(P <0.05 to P<0.01), the time of operation duration and patients awakening in group D were shorter(P<0.01), the dosage of remifentanil and midazolam in group D were less(P<0.01), and the incidence of respiratory depression was lower(P<0.05).Conclusions:The clinical effect of dezocine combined with remifentanil in the sedation and analgesia of Alzheimer's disease patients treated with phacoemulsification is good, which is a safe method of anesthesia.
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Key words:
- cataract /
- phacoemulsification /
- Alzheimer's disease /
- dezocine /
- remifentanil /
- conscious sedation
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