全麻诱导中右旋美托咪定的镇静效应及对丙泊酚用量的影响  

The influence of dexmedetomidine on sedation and requirment of propofol during anesthesia induction

作　　者：斯妍娜[1] 施韬[1] 鲍红光[1] 

机构地区：[1]南京医科大学附属南京第一医院麻醉科,210006

出　　处：《临床麻醉学杂志》2010年第12期1053-1055,共3页Journal of Clinical Anesthesiology

基　　金：南京医科大学科技发展基金项目(2010NJMU052)

摘　　要：目的研究全麻诱导中右旋美托咪定(Dex)的镇静效应及对丙泊酚用量的影响。方法选择30例择期全麻手术患者,ASAⅠ或Ⅱ级,随机分成Dex组(D组)和对照组(C组),每组15例。D组以1μg/kgDex稀释成10ml、C组以生理盐水分别静脉泵注10min,给药后20min泵注丙泊酚0.4mg·kg-1.min-1,托下颌无体动时给予芬太尼1μg/kg和罗库溴铵0.6mg/kg,1.5min后进行气管内插管。记录用药前(T0)、用药后5min(T1)、10min(T2)、20min(T3)的反应指数(RE)、状态指数(SE)、Ramsay评分。记录睫毛反射消失时丙泊酚最小诱导量和丙泊酚诱导总用量。结果 T1～T3时D组SE、RE显著低于C组和T0时(P<0.01),Ramsay评分明显高于C组和T0时(P<0.01)。D组丙泊酚最小诱导量和诱导总量明显低于C组(P<0.01)。结论 Dex1μg/kg诱导可以产生明显的镇静效应,无呼吸抑制作用,可减少诱导时丙泊酚用量。Objective To evaluate the influence of dexmedetomidine（Dex） on sedation and requirement of propofol during anesthesia induction. Methods Thirty patients（ASA Ⅰ or Ⅱ） undergoing selective operation were randomly divided into 2 groups：Dexmedetomidine group （group D,n=15） or control group （group C,n=15）. Patients in the group D received 1 μg/kg dex diluted to 10ml over 10 min by pumped infusion and patients in the group C was simply recieved normol saline at the same way.Twenty minutes after administrating the drug,patients in both groups were pumped propofol at the speed of 0.4 mg·kg-1·min-1. When holding up jaw without movement,patients received 1 μg/kg fentanyl and 0.6 mg/kg rocuronium,and endotracheal intubated 1.5 minutes later. RE,SE,Ramsay sedation scale of the patients were recorded before（T0） and after 5,10,20 minutes（T1-T3） of drug adminstration.The minimum dose and total dose of propofol during induction were recorded.Results Compared with group C and T0,RE and SE in group D decreased obviously at T1-T3 （P0.01）,while Ramsay sedation scale rised significantly （P0.01）. Compared with group C,the minimum dose and the total dose of propofol decreased obviously in group D during induction （P0.01）.Conclusion Dexmedetomidine causes sadetive without respiratory depression,and has the propofol sparing effect during anesthesia induction.

关 键 词：右旋美托咪定 丙泊酚 反应指数 状态指数 

分 类 号：R614[医药卫生—麻醉学]