中国医疗设备2016，Vol.31Issue(6)：123-126,4.DOI:10.3969/j.issn.1674-1633.2016.06.035
右美托咪定-氯胺酮复合麻醉在老年硬膜外关节镜手术中的研究
Study on Application of Dexmedetomidine-ketamine Epidural Anesthesia in Arthroscopic Operation in the Elderly
张茹 1张昊1
作者信息
- 1. 北京市隆福医院 麻醉科，北京100010
- 折叠
摘要
Abstract
Objective To investigate the effects of application of dexmedetomidine-ketamine epidural sedation in arthroscopic operation in elderly patients.Methods Altogether 60 cases of patients who underwent knee arthroscopy in the hospital from January 2013 to January 2015 were selected as research subjects and assessed as Grade I or II in line with ASA classiifcation standards. According to random number table method, all these patients were divided into Observation Group and Control Group with 30 cases in each group. Two groups of patients accepted epidural anesthesia. Observation Group was given dexmedetomidine ketamine intravenous anesthesia, while Control Group was given target-controlled infusion of propofol and intravenous fentanyl combined anesthesia. Indicators such as OAA/S (The Observer’ Assessment of Alertness/Sedation Scale) score, bispectral index (BIS), blood oxygen saturation (SpO2), mean arterial pressure (MAP), heart rate (HR) and blood pressure (BP) were observed, and induction time, recovery time and adverse reaction conditions were recorded. Satisfaction survey of operators and patients were conducted after the surgery.ResultsPatients in Observation Group had stable breathing during the operation with average SpO2 higher than 96%. Partial pressure of end-tidal carbon dioxide was normal. A total of 21 cases in Control Group had SpO2 less than 90%; 11 patients had respiratory pause and needed to be placed through the airway and (or) assisted with ventilation. The differences between the two groups were statistically signiifcant (P<0.05). Hemodynamics in Observation Group was more stable than that in Control Group. However, when the BIS≤60, the heart rate decreased signiifcantly. The induction time and recovery time of Observation Group were longer than those of Control Group (P<0.05). Patients and operators of the two groups had similar satisfaction rate to narcotic effects. ConclusionDexmedetomidine-ketamine epidural anesthesia is a safe method for elderly patients with epidural anesthesia in arthroscopic surgery, with stable hemodynamic indicators and without signiifcant inhibition of respiration, which is worthy of clinical application.关键词
右美托咪定/氯胺酮/麻醉/膝关节镜Key words
dexmedetomidine/ketamine/anesthesia/knee arthroscopy分类
医药卫生引用本文复制引用
张茹,张昊..右美托咪定-氯胺酮复合麻醉在老年硬膜外关节镜手术中的研究[J].中国医疗设备,2016,31(6):123-126,4.
