下肢手术中应用右美托咪定用于腰-硬联合麻醉自控镇静的研究

摘要

Objective: To analyze the effect of Dexmedetomidine for combined spinal epidural anesthesia controlled sedation in lower extremity surgery.Methods: 20 cases lower extremity surgery from January 2014-December 2015, in our hospital performed combined spinal epidural anesthesia controlled sedation with Dexmedetomidine, and the effect was observed.Results: The average operation time is 85 min during minimally invasive percutaneous pedicle internal fixation combined with calcium sulphate strengthening treatment of thoracolumbar vertebral bodies of artificial bone fracture surgery. The average intraoperative blood loss is 80 mL, and the average hospitalization time is 11.5 d, follow-up time is 18 months. No spinal cord, nerve damage or wound infection showed, and no internal fixation of fracture, loose showed. During postoperative immediate and final follow-up, vertebral front and rear height and normal fanterior, the ratio between the depth of the trailing edge and Cobb angle were improved compared with preoperative (P<0.05).Conclusion: Dexmedetomidine for combined spinal epidural anesthesia controlled sedation in lower extremity surgery can achieve good anaesthesia effect, was easy to operate, and increased patients' comfort level, thus has clinical value.%目的：分析研究下肢手术中应用右美托咪定用于腰-硬联合麻醉自控镇静的效果。方法：选取2014年1月—2015年12月我院诊治的胸腰椎骨折患者共20例，对20例患者在下肢手术当中采取右美托咪定用于腰-硬联合麻醉自控镇静，对其临床效果给予分析研究。结果：微创经皮椎弓根内固定结合硫酸钙人工骨强化椎体治疗胸腰椎骨折术平均手术时间85min，平均术中出血量80mL，平均住院时间11.5d，平均随访时间18个月。无脊髓、神经损伤及伤口感染，无内固定断裂、松动。术后即刻和终末随访时，患者伤椎前、后缘高度与正常椎体前、后缘高度的比值和Cobb角度均较术前改善(P<0.05)。结论：在下肢手术当中采取右美托咪定应用于腰-硬联合麻醉自控镇静，可以取得良好的麻醉效果，并且操作简便，使患者舒适度明显提高，具有临床推广价值。