右旋美托咪啶对冠状动脉旁路移植术患者气管插管时的血流动力学影响  

Effects of dexmedetomidine on haemodynamic response to endotracheal intubation in patients undergoing myocardial revascularization

作　　者：葛云芬[1] 严美娟[1] 

机构地区：[1]浙江省人民医院麻醉科,杭州310014

出　　处：《中国临床药理学杂志》2011年第5期392-394,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察右旋美托咪啶(镇静药)和小剂量舒芬太尼(麻醉药)在服用β-受体阻滞剂的冠状动脉旁路移植术患者麻醉诱导时的血流动力学状态。方法选择30例欲行冠状动脉旁路患者,随机分为2组:对照组,使用生理盐水;试验组,在麻醉诱导前,使用右旋美托咪啶0.5μg.kg-1,接着持续用0.5μg.kg-1.h-1,记录基础、安慰剂或右旋美托咪啶注射后、全麻诱导后及气管内插管后1,3,5 min时的血压和心率。结果试验组,各个时间点的SAP、DAP和MAP与基础值相比明显降低,有统计学差异(P<0.05);在麻醉诱导后(T2)与对照组相比,有统计学差异(P<0.05);在试验药物注射后(T1)、气管插管后1m in(T3)与对照组相比明显降低,有统计学差异(P<0.05);试验组的心率,在气管插管后与对照组相比明显降低,有统计学差异(P<0.05)。结论冠状动脉旁路移植术患者使用右旋美托咪啶,安全并可降低麻醉诱导时的血流动力学反应。Objective To examine the haemodynamic response to endotrachal intubation with dexmedetomidine and low dose sufentanyl in patients undergoing myocardial revascularization receiving beta bloker treatment.Methods Thirty patients undergoing myocardial revascularization received in a double blind manner,either a saline（control group）or a dexmedetomidine infusion（0.5 μg·kg^-1）（treatment group）before the anesthesia induction.Heart rate（HR） and blood pressure（BP） were monitored at baseline,after saline or dexmedetomidine infusion,after induction of general anesthesia,1,3 and 5 minutes after endotracheal intubation.Results In the treatment group,systolic arterial pressures（SAP）,diastolic arterial pressures（DAP） and mean arterial pressures（MAP） were lower at all times in comparison to baseline values.After a saline or a dexmedetomidine infusion and 1 minute after endotracheal intubation,in the treatment group,SAP,DAP and MAP were lower than the control group.While after the induction of general anesthesia,SAP,DAP,MAP in the treatment group were higher than the control group.After endotracheal intubation,HR significantly increased in control group while it decreased in treatment group.Conclusion Dexmedetomidine can safely be used to attenuate the hemodynamic response to endotrachal intubation in patients undergoing myocardial revascularization receiving beta bloker treatment.

关 键 词：右旋美托咪啶 冠状动脉旁路移植术 麻醉诱导 

分 类 号：R971.3[医药卫生—药品] R543.31[医药卫生—药学]