目的：对比右美托咪定与咪达唑仑计划镇静对老年经尿道前列腺电切术（ transurethral resection of the prostate ，TURP）患者的围术期镇静效果。方法：选取2013年5月—2015年5月深圳市光明新区人民医院收治的择期行TURP的老年患者150例为研究对象，以随机数字表法将患者分为对照组（A组）、右美托咪定组（B组）和咪达唑仑组（C组）各50例。所有患者先腰硬联合麻醉后，A组予以0.9％氯化钠注射液20 ml；B组予以右美托咪定0.75μg／kg，稀释至20 ml；C组予以咪达唑仑0.03 mg／kg，稀释至20 ml，使用注射泵将药品20 min缓慢静脉内泵注。记录患者治疗过程中的平均动脉压（ MVP）、血氧饱和度（ SpO2）、心率、Ramsay镇静评分。结果：治疗后，A组患者的MVP、SpO2、心率变化不大；B组患者的SpO2未出现下降，C组患者的SpO2随镇静时间出现下降；B、C组的MVP下降，差异均无统计学意义（P＞0.05）；B组患者心率下降程度大于C组，差异有统计学意义（P＜0.05）。 B、C组患者的Ramsay评分均＞3分。结论：右美托咪定和咪达唑仑都具有较好的镇静效果，右美托咪定易产生心脏抑制，咪达唑仑易产生呼吸抑制。%OBJECTIVE:To compare the sedative effects of dexmedetomidine and midazolam in treatment of senile patient with TURP during perioperation . METHODS: 150 senile patients with TURP admitted into Shenzhen Gguangming New District People's Hospital from May 2013 to May 2015 were selected to be divided into control group ( group A ) , dexmedetomidine group ( group B ) and midazolam group ( group C ) via the random number table , with 50 cases in each.All patients were treated with combined spinal-epidural anesthesia before used sedative .Group A were given 0.9%sodium chloride solution 20 ml;group B received 0.75μg/kg dexmedetomidine , with dilution of 20 ml; and group C were treated with 0.03 mg/kg midazolam, with dilution of 20 ml.Drugs were slowly and intravenously pumped by injection pump within 20 min.The MVP, SpO2 , HR and Ramsay sedation scores of two groups were recorded.RESULTS:After treatment, the MVP, SpO2, HR of group A showed no obvious change;SpO2 of group B did not decline;SpO2 of group C declined by sedation , and the MVP of group B and group C declined , with statistically significant difference ( P>0.05 ) .The decline range of HR of group B was larger than that of group C , with statistically significant difference ( P<0.05 ) .The Ramsay score of two groups were over three .CONCLUSIONS:The sedative effects of dexmedetomidine and midazolam were relatively good;dexmedetomidine is likely to has cardiac depression , and midazolam is likely to has respiratory depression .
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