摘要
Abstract
Objective To evaluate the sedation efficacy and safety of intramuscular dexmedetomidine ( Dex) in patients with elective abdominal hysterectomy using combined spinal - epidural anesthesia ( CSEA) . Methods One -hundred patients scheduled for elective abdominal hysterectomy were enrolled and randomly divided into 5 groups ( n = 20). The control ( C) group and the other 4 groups ( D1 , D2, D3 and D4 ) were given intramuscularly injection of 3 mL normal saline and Dex with 0,1.5, 2.0, 2.5 and 3.0 μg/kg, respectively. SBP, DBP, HR, pulse oxygen saturation ( SpO2) , bispectal analysis index were recorded every 5 min after the patients entered operating room. The assessment of alertness/sedation scale (OAA/S) was evaluated every 5 min after Dex or normal saline was given intramuscularly. The overall sedative satisfaction and related complications (hypotension, hypertension, bradycardia, shivering, and et al. ) was followed up in 24 h. Results Flowing with the increase of Dex, the overall sedative satisfaction degree was increased. Compared with Group D1 and D2, the patients in Group D3 and D4 were more satisfied with the sedation effects, while the over sedation rate (50% ) in group D4 was significantly higher than those in other groups (P ＜0. 05) . Although there was no significant difference in the onset time of sedative effect among D2, D3 and D4 group, which were about 15 min, the peak sedative effects were delayed in a dose - dependent manner with the increase of Dex. Compared with that in Group C, the incidences of hypotension in group D1 and D2 were higher, and so were the incidences of bradycardia in group D3 and D4. Conclusion Intramuscular 2. 5 μg/kg Dex can provide satisfactory sedative effect for the patients with elective abdominal hysterectomy unsing CSEA, though the Dex -induced bradycardia should be concerned.关键词
右美托咪定/肌肉注射/镇静/腰硬联合麻醉Key words
dexmedetomidine/intramuscular/sedation/combined spinal - epidural anesthesia
