Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation.

Ebru Tarıkçı Kılıç, Gaye Aydın
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引用次数: 12

Abstract

Background: We evaluated the effects of intravenous dexmedetomidine during spinal anesthesia on hemodynamics, respiratory rate, oxygen saturation, sedpain, and compared them with those of saline infusion. Sixty American Society of Anesthesiologists physical status I and II cases were randomly divided into two groups. Patients were connected to the monitor after premedication, and spinal anesthesia was administered. Sensory and motor blockades were assessed using pinprick test and Bromage scale, respectively. Group I received dexmedetomidine infusion and Group II received saline infusion. Throughout the infusion process, hemodynamic data, respiratory rate, oxygen saturation, sedation, pain, Bromage score, amnesia, bispectral index, and side effects were recorded. Postoperative hemodynamic measurements, oxygen saturation, sedation, pain scores were obtained. Sedation and pain were evaluated using the Ramsay and visual analog scales, respectively. Analgesics were administered in cases with high scores on the visual analog scale. Postoperative analgesic consumption, side effects, treatments were recorded. No significant differences were found between the groups with respect to oxygen saturation, respiratory rate, pain, and side effects in the intraoperative period. Time to onset of sensorial block, maximum sensorial block, onset of motor block, and maximum motor block; bispectral index values; and apex heartbeat until 80 min of infusion, systolic arterial blood pressure until 90 min, and diastolic arterial blood pressure until 50 min were lower, whereas amnesia and sedation levels were higher in dexmedetomidine group. Postoperative pain and analgesic requirement were not different. Apex heartbeat at 15 min and systolic arterial blood pressure at 30 min were lower and sedation scores were higher in the dexmedetomidine infusion group. We demonstrated dexmedetomidine infusion had a hemodynamic depressant effect intraoperatively whereas it had no significant effect on peripheral oxygen saturation, respiratory rate, visual analog scale scores, and side effects. Dexmedetomidine infusion enhanced motor and sensory blockade quality and induced amnesia and sedation.

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脊髓麻醉中右美托咪定输注对血流动力学和镇静的影响。
背景:我们评估脊髓麻醉时静脉注射右美托咪定对血液动力学、呼吸速率、血氧饱和度、镇静疼痛的影响,并与生理盐水输注进行比较。60例美国麻醉医师学会物理状态I和II的病例随机分为两组。预用药后连接监护仪,给予脊髓麻醉。感觉阻滞和运动阻滞分别采用针刺试验和Bromage量表进行评估。组1静脉滴注右美托咪定,组2静脉滴注生理盐水。在整个输注过程中,记录血流动力学数据、呼吸频率、血氧饱和度、镇静、疼痛、Bromage评分、失忆、双谱指数和副作用。术后血流动力学测量、血氧饱和度、镇静、疼痛评分。镇静和疼痛分别采用Ramsay和视觉模拟量表进行评估。在视觉模拟量表上得分高的病例给予镇痛药。记录术后镇痛药用量、不良反应、治疗情况。两组患者术中氧饱和度、呼吸频率、疼痛及副作用无明显差异。感觉阻滞、最大感觉阻滞、运动阻滞和最大运动阻滞发生的时间;双谱指标值;右美托咪定组80min前心尖心跳、90min前收缩压、50min前舒张压较低,遗忘和镇静水平较高。术后疼痛和镇痛需求无差异。右美托咪定输注组15 min心尖和30 min收缩压较低,镇静评分较高。我们证明右美托咪定输注术中具有血流动力学抑制作用,而对外周氧饱和度、呼吸速率、视觉模拟评分和副作用没有显著影响。右美托咪定输注增强运动和感觉阻滞质量,诱导健忘症和镇静。
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