河北医科大学学报

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右美托咪定辅助镇静对行椎管内麻醉的2型糖尿病老年患者术后睡眠状态的影响

  

  1. 1.河北省晋州市人民医院麻醉科,河北 晋州 052260;2.河北省石家庄市第一医院麻醉科,河北 石家庄 050011;
    3.河北省泊头市人民医院麻醉科,河北 泊头 062150;4.河北省元氏县医院麻醉科,河北 元氏 051130
  • 出版日期:2016-11-25 发布日期:2016-12-14
  • 作者简介:赵通( 1973- ),男,河北晋州人,河北省晋州市人民 医院麻醉科副主任医师,医学学士,从事临床麻醉学研究。
  • 基金资助:
    河北省医学科学研究重点课题( 20150916)

Effect of dexmedetomidine on sedation on  the postoperative sleep status of  type 2 diabetes elderly patients undergoing spinal anesthesia

  1. 1.Department of Anesthesia, the People′s Hospitol of Jinzhou City, Hebei Province, Jinzhou 052260,
    China; 2.Department of Anesthesia, the First Hospitol of Shijiazhuang City, Hebei Province,
    Shijiazhuang 050011, China; 3.Department of Anesthesia, the People′s Hospitol Botou
    City, Hebei Province, Botou 062150, China; 4.Department of  Anesthesia, the
    Hospitol of Yuanshi County, Hebei Province, Yuanshi 051130, China
  • Online:2016-11-25 Published:2016-12-14

摘要: [摘要] 目的 评估右美托咪定辅助镇静对行椎管内麻醉的糖尿病老年患者术后睡眠状态的影响。方法 择
期椎管内麻醉下行大隐静脉高位结扎和剥脱手术的糖尿病患者 40 例,采用随机数字表法分为右美托咪定组和对
照组各 20 例。所有患者术前 1d 采用匹兹堡睡眠质量指数( PittsburghSleepQualityIndex , PSQI )评估术前 1 个月
的睡眠情况。腰硬联合麻醉后,右美托咪定组开始持续静脉输注右美托咪定镇静 0.2 μ g ·
kg
-1 · h -1 ,对照组输注
等量生理盐水。术中 2 组均于腰硬联合穿刺完成后即刻( T 1 )、手术开始 1h ( T 2 )、术毕( T 3 )时刻抽取静脉血监测血
糖。术后 1 个月所有患者再次采用 PSQI 评估术后睡眠质量。结果 2 组 T 1 ~T 3 时刻血糖值组间、时点间、组间·
时点间交互作用差异均无统计学意义( P >0.05 )。术前 2 组 PSQI 评分差异无统计学意义(
P >0.05 ),术后 1 个月
2 组 PSQI 评分均低于术前,且右美托咪定组低于对照组( P <0.05

关键词: 糖尿病, 2型, 麻醉, 脊椎, 右美托咪定, 睡眠

Abstract: [
Abstract ] Objective Toevaluatetheeffectofdexmedetomidineassistedsedationonthe
postoperativesleepstatusofelderlydiabetespatientsundergoingspinalanesthesia.Methods
Fortypatientsunderspinalanesthesiaonsaphenousveinligationandstrippingelectivesurgery
wererandomlydividedintotwogroups ( n =20 ): dexmedetomidinesedationgroup ( groupD ) and
controlgroup ( groupC ) .Thesleepqualityoflastmonthinallthepatientswereassessedusing
thePittsburghSleep QualityIndex ( PSQI ) thedaybeforeoperation.Whenlumbarepidural
anesthesiakeepstable , groupDbegancontinuousintravenousinfusionwithdexmedetomidine0.2
μ g ·
kg
-1 · h -1 ,
groupCwithsalineinfusion.Bothgroupswerebloodglucosemonitoredatthree
timepoints : immediatelyafterpuncture ( T 1 ), onehouraftertheoperationstart ( T 2 ), attheend ofoperation ( T 3 ) .OnemonthlaterthesleepqualityofallthepatientswereassessedusingPSQI
onceagain.Results Therewasnosignificantdifferenceincomparisonofbloodglucoselevels
betweenthetwogroups , betweentheT 1 -T 3 timepoints , andbetweentheinteractionofgroup · time
points ( P >0.05 ), andnodifferenceinthePSQIscores (
P >0.05 ), whilepostoperativePSQI
scoresinthetwogroupswerelowerthanthatbeforeoperation , andthedexmedetomidinegroup
waslowerthanthatofthecontrolgroup ( P <0.05 ) .Conclusion Dexmedetomidinegivenspinal
anesthesiaassistsedationcanimprovepostoperativesleepstatusoftheelderlypatientswithtype
2diabetetoacertainextent.

Key words: diabetesmellitus, type2 , anesthesia, spinal , dexmedetomidine , sleep