• 主题
高级搜索  >
历史搜索 清空历史
首页> 美国卫生研究院文献>Frontiers in Pharmacology >The Safety and Efficacy of Dexmedetomidine vs. Sufentanil in Monitored Anesthesia Care during Burr-Hole Surgery for Chronic Subdural Hematoma: A Retrospective Clinical Trial
【2h】

The Safety and Efficacy of Dexmedetomidine vs. Sufentanil in Monitored Anesthesia Care during Burr-Hole Surgery for Chronic Subdural Hematoma: A Retrospective Clinical Trial

机译：右美托咪定与舒芬太尼在慢性硬脑膜下血肿Burr-Hole手术中的麻醉监测中的安全性和有效性：回顾性临床试验。

代理获取
本网站仅为用户提供外文OA文献查询和代理获取服务，本网站没有原文。下单后我们将采用程序或人工为您竭诚获取高质量的原文，但由于OA文献来源多样且变更频繁，仍可能出现获取不到、文献不完整或与标题不符等情况，如果获取不到我们将提供退款服务。请知悉。
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

>Background: Chronic subdural hematoma (CSDH) is a very common clinical emergency encountered in neurosurgery. While both general anesthesia (GA) and monitored anesthesia care (MAC) can be used during CSDH surgery, MAC is the preferred choice among surgeons. Further, while dexmedetomidine (DEX) is reportedly a safe and effective agent for many diagnostic and therapeutic procedures, there have been no trials to evaluate the safety and efficacy of DEX vs. sufentanil in CSDH surgery.>Objective: To evaluate the safety and efficacy of DEX vs. sufentanil in MAC during burr-hole surgery for CSDH.>Methods: In all, 215 fifteen patients underwent burr-hole surgery for CSDH with MAC and were divided into three groups: Group D1 (n = 67, DEX infusion at 0.5 μg·kg−1 for 10 min), Group D2 (n = 75, DEX infusion at 1 μg·kg−1 for 10 min), and Group S (n = 73, sufentanil infusion 0.3 μg·kg−1 for 10 min). Ramsay sedation scale (RSS) of all three groups was maintained at 3. Anesthesia onset time, total number of intraoperative patient movements, hemodynamics, total cumulative dose of DEX, time to first dose and amount of rescue midazolam or fentanyl, percentage of patients converted to alternative sedative or anesthetic therapy, postoperative recovery time, adverse events, and patient and surgeon satisfaction scores were recorded.>Results: The anesthesia onset time was significantly less in group D2 (17.36 ± 4.23 vs. 13.42 ± 2.12 vs. 15.98 ± 4.58 min, respectively, for D1, D2, S; P < 0.001). More patients in groups D1 and S required rescue midazolam to achieve RSS = 3 (74.63 vs. 42.67 vs. 71.23%, respectively, for D1, D2, S; P < 0.001). However, the total dose of rescue midazolam was significantly higher in group D1 (2.8 ± 0.3 vs. 1.9 ± 0.3 vs. 2.0 ± 0.4 mg, respectively, for D1, D2, S; P < 0.001). The time to first dose of rescue midazolam was significantly longer in group D2 (17.32 ± 4.47 vs. 23.56 ± 5.36 vs. 16.55 ± 4.91 min, respectively, for D1, D2, S; P < 0.001). Significantly fewer patients in groups S and D2 required rescue fentanyl to relieve pain (62.69 vs. 21.33 vs. 27.40%, respectively, for D1, D2, S; P < 0.001). Additionally, total dose of rescue fentanyl in group D1 group was significantly higher (212.5 ± 43.6 vs. 107.2 ± 35.9 vs. 98.6 ± 32.2 μg, respectively, for D1, D2, S; P < 0.001). Total number of patient movements during the burr-hole surgery was higher in groups D1 and S (47.76 vs. 20.00 vs. 47.95%, respectively, for D1, D2, S; P < 0.001). Four patients in D1 and five in S converted to propofol. The time to recovery for discharge from the PACU was significantly shorter in group D2 (16.24 ± 4.15 vs. 12.48 ± 3.29 vs. 15.91 ± 3.66 min, respectively, for D1, D2, S; P < 0.001). Results from the patient and surgeon satisfaction scores showed significant differences favoring group D2 (P < 0.05). More patients in groups D1 and S showed higher levels of the overall incidence of tachycardia and hypertension, and required higher doses of urapidil and esmolol (P < 0.05). Six patients experienced respiratory depression in group S.>Conclusion: Compared with sufentanil, DEX infusion at 1 μg·kg−1 was associated with fewer intraoperative patient movements, fewer rescue interventions, faster postoperative recovery, and better patient and surgeon satisfaction scores and could be safely and effectively used for MAC during burr-hole surgery for CSDH.
机译：>背景：慢性硬膜下血肿（CSDH）是神经外科中非常常见的临床急症。虽然CSDH手术可同时使用全身麻醉（GA）和监测麻醉护理（MAC），但MAC是外科医生中的首选。此外，虽然据报道右美托咪定（DEX）可用于许多诊断和治疗程序，但目前尚无任何试验评估DEX与舒芬太尼在CSDH手术中的安全性和有效性。>目的：为了评估DEX与舒芬太尼在CSDH毛孔手术中的安全性和有效性。>方法：总共有215例15例接受MAC的CSDH毛刺手术，分为三例组：D1组（n = 67，以0.5μg·kg -1 进行10分钟的DEX输注），D2组（n = 75，以1μg·kg −1 < / sup> 10分钟）和S组（n = 73，输注舒芬太尼0.3μg·kg -1 10分钟）。所有三组的Ramsay镇静量表（RSS）维持在3。麻醉开始时间，术中患者移动的总数，血液动力学，DEX的总累积剂量，首次给药的时间和咪达唑仑或芬太尼的抢救量，已转化患者的百分比替代了镇静或麻醉疗法，记录了术后恢复时间，不良事件以及患者和外科医生的满意度得分。>结果：D2组的麻醉起效时间明显缩短（17.36±4.23 vs. 13.42±对于D1，D2，S，分别为2.12和15.98±4.58分钟; P <0.001）。 D1和S组中的更多患者需要抢救咪达唑仑以达到RSS = 3（对于D1，D2，S，分别为74.63％对42.67％对71.23％； P <0.001）。然而，D1组的抢救性咪达唑仑的总剂量显着更高（D1，D2，S分别为2.8±0.3 vs. 1.9±0.3 vs. 2.0±0.4 mg； P <0.001）。 D2组首次给予咪达唑仑抢救的时间明显更长（D1，D2，S组分别为17.32±4.47 vs. 23.56±5.36 vs. 16.55±4.91 min； P <0.001）。 S组和D2组中需要挽救芬太尼以缓解疼痛的患者显着减少（D1，D2，S组分别为62.69％，21.33％和27.40％； P <0.001）。此外，D1组的芬太尼抢救总剂量明显更高（D1，D2，S分别为212.5±43.6 vs. 107.2±35.9 vs. 98.6±32.2μg； P <0.001）。 D1和S组的毛刺手术患者移动总数更高（D1，D2，S组分别为47.76 vs. 20.00 vs. 47.95％； P <0.001）。 D1中的4名患者和S中的5名患者转换为丙泊酚。 D2组中从PACU放电恢复的时间明显缩短（D1，D2，S组分别为16.24±4.15 vs. 12.48±3.29 vs. 15.91±3.66 min； P <0.001）。患者和外科医生的满意度评分结果表明，D2组有显着差异（P <0.05）。 D1和S组中更多的患者显示出心动过速和高血压的总体发生率较高，并且需要更高剂量的乌拉地尔和艾司洛尔（P <0.05）。 S组中有6例患者出现呼吸抑制。>结论：与舒芬太尼相比，以1μg·kg -1 输注DEX与术中患者动作减少，救援干预措施减少，术后恢复更快，患者和医生的满意度更高，可以安全有效地用于CSDH钻孔手术中的MAC。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
代理获取

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号