用德克斯梅托米丁镇静进行骨科上肢手术的患者的周术性低血压:一项回顾性研究
Sujin Baek1,2, Jiyong Lee1,2, Yong Sup Shin1,2
1Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea.
Journal of personalized medicine
|December 23, 2023
概括
德克斯梅德托米丁在上肢手术中增加了低血压的风险. 风险因素包括β-阻断剂的使用和更长的手术持续时间,需要在服用前仔细考虑.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 有限的数据存在于外周神经阻塞期间用于手术内镇静的德克斯梅德托米丁的低血压风险.
- 调查外科手术期间低血压的危险因素对于患者的安全至关重要.
研究的目的:
- 为了确定德克斯梅托米丁与米达佐拉姆相比或在腕阻塞期间没有镇静治疗的患者中低血压的发生率.
- 在接受手术内镇静的患者中识别与低血压相关的危险因素.
主要方法:
- 单一中心对2152名接受了骨科上肢手术的患者进行了回顾性研究.
- 患者按镇静剂分组:非镇静剂,米达佐拉姆或德克斯梅德托米丁.
- 低血压定义为SBP<90 mmHg或MBP<60 mmHg;使用多变量后勤模型.
主要成果:
- 与非镇静剂相比,德克斯梅德托米丁组的低血压几率比率 (5.68) 显著更高.
- 低血压的重要危险因素包括同时使用β-阻断剂,更长的手术持续时间,更低的手术前SBP,和更高的手术前心率.
- 1029名患者接受了德克斯梅德托米丁,678名患者接受了米达佐拉姆,445名患者没有接受镇静.
结论:
- 在接受外围神经阻塞的患者中,德克斯梅德托米丁与外科手术期间低血压的风险增加有关.
- 麻醉科医生应考虑确定的风险因素,然后在注射德克斯梅德米丁进行手术内镇静.
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