脊髓麻醉下泌尿外科手术中右旋门铎与得普利麻镇静的比较特点

Sergiy Redko, Y. Shkatula, Yuliia A. Tkachenko, Diana A. Steblovskaya
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摘要

目前,麻醉师-复苏师使用大量镇静剂(催眠药、全麻药、抗焦虑药),但其中许多除了主要作用外,还会产生一些副作用或不能提供最佳镇静作用。另一方面,随着现代镇静新药的出现,对现有镇静治疗方案进行修正是十分及时和必要的。本研究的目的是探讨不同镇静方法在泌尿外科脊柱麻醉下手术的利弊。对80例在平衡麻醉(脊髓麻醉联合药物镇静)下行泌尿外科手术的患者(男54例,女26例)进行了研究。患者随机分为两组。组1 (n = 40) -用右旋门酮镇静,组2 (n = 40) -用地普麻镇静。采用RAMSEY量表评估镇静水平,采用Bidway五分制评估麻醉后恢复程度,采用Lowa麻醉满意度量表(ISAS)评估麻醉满意度。通过连续监测心率、血压和心电图来确定血流动力学障碍的程度。使用Shapiro-Wilk方法检验分布的正态性。采用Mann-Whitney检验评估两独立组间差异的统计学意义。结果。研究表明,在手术期间,第二组观察到更深层次的镇静(用得普利麻镇静)。在这组患者中,术后15分钟和30分钟的困倦程度也更高。尽管接受dexdor的患者有更多的表面镇静,但他们总体上对麻醉的满意度明显更高。本研究证实了两种药物用于泌尿外科脊髓麻醉患者镇静的有效性和安全性。然而,与异丙酚相比,我们发现了许多重要的优点。右旋多,由于其能够引起轻度至中度镇静,使患者能够接触工作人员,几乎不抑制呼吸,让患者感到舒适,并引起充分的逆行性遗忘。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COMPARATIVE CHARACTERISTICS OF DEXDOR AND DIPRIVAN FOR SEDATION IN UROLOGICAL OPERATIONS UNDER SPINAL ANESTHESIA
Currently, anesthesiologists-resuscitators have a large number of sedatives (hypnotics, general anesthetics, anxiolytics), but many of them, in addition to the main action, give a number of side effects or do not provide optimal sedation. On the other hand, there are new modern drugs for sedation, thus, the need to correct existing regimens of sedative therapy is quite timely and necessary. The aim of the study was to examine the advantages and disadvantages of different sedation methods in patients with urological profile operated under spinal anesthesia. 80 patients (54 men and 26 women) who underwent urological surgery under balanced anesthesia (spinal anesthesia in combination with drug sedation) were examined. Patients were randomly divided into two groups. Group 1 (n = 40) – sedation with dexdor, group 2 (n = 40) – sedation with diprivan. The level of sedation was assessed using the RAMSEY scale, the degree of post-anesthesia recovery on the Bidway five-point scale, and anesthesia satisfaction was assessed using the Lowa Satisfaction with Anesthesia Scale (ISAS). The degree of hemodynamic disorders was determined by continuous monitoring of heart rate, blood pressure and ECG. The normality of the distribution was checked using the Shapiro–Wilk method. The Mann–Whitney test was used to assess the statistical significance of the difference between the two independent groups. Results. The study showed that a deeper level of sedation during surgery was observed in the second group (sedation with diprivan). In this group, postoperative drowsiness was also higher both during the first 15 minutes and 30 minutes after surgery. Despite the fact that patients receiving dexdor had more superficial sedation, they generally showed significantly higher overall satisfaction with anesthesia. The study proved the effectiveness and safety of both drugs for sedation in urological patients under spinal anesthesia. However, a number of important advantages of dexdor were found as compared to diprivan. Dexdor, due to its ability to cause mild to moderate sedation, allows the patient to contact staff, almost does not suppress respiration, lets the patient feel comfortable and causes sufficient retrograde amnesia.
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