右美托咪定对高血压患者全身麻醉拔管期的影响  

Effect of Dexmedetomidine during Extubation Period after General Anesthesia in Patients with Hypertension

作　　者：刘贤琼[1] 蒋民霞[1] 彭莉芳[1] 方全凤[2] 王遂之[1] 

机构地区：[1]吉安市中心人民医院麻醉科 [2]井冈山大学附属医院ICU,江西吉安343000

出　　处：《南昌大学学报（医学版）》2011年第7期76-78,共3页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨右美托咪定对高血压患者全身麻醉拔管期的影响。方法将60例ASAⅠ-Ⅱ级、行择期盆腹腔开放性手术的高血压患者按随机数字表法分为2组:右美托咪定组(A组)和对照组(B组),每组30例。术毕前30 min A、B 2组患者分别采用静脉微量注射泵泵注0.5μg.kg-1右美托咪定和等量的生理盐水。观察2组患者的手术时间和用药前、拔管前、拔管时,拔管后51、0 min的HR、SBP、DBP、SpO2及术后睁眼时间、拔管时间、有无躁动等情况。结果手术时间:A组为(123.0±15.2)min,B组为(125.0±12.1)min,2组比较差异无统计学意义(P>0.05)。拔管前、拔管时,拔管后5、10 min A组患者的SBP、DBP、HR值均明显低于B组(P<0.05或P<0.01);用药前、拔管前、拔管时,拔管后51、0 min 2组患者的SpO2值比较差异均无统计学意义(均P>0.05)。2组患者术后睁眼时间、拔管时间比较差异均无统计学意义(P>0.05)。A组患者术后躁动(1-3级)发生率均明显低于B组(P<0.05或P<0.01)。结论术毕前30 min静脉微量注射泵泵注0.5μg.kg-1右美托咪定,能有效地减轻高血压患者拔管期的心血管反应及稳定血流动力学,降低术后躁动发生率。Objective To explore the effect of dexmedetomidine during extubation period after general anesthesia in patients with hypertension.Methods Sixty ASA Ⅰ-Ⅱ patients with hypertension undergoing elective abdominal surgery were randomly assigned to receive either intravenous infusion of 0.5 μg·kg-1 dexmedetomidine（group A,n=30） or intravenous infusion of the same amount of normal saline（group B,n=30） at 30 minutes before the end of operation.Operation time,time of eye opening,extubation time,and restlessness were observed.Systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR） and pulse oxygen saturation（SpO2） were recorded before infusion,before extubation,during extubation,and 5 and 10 minutes after extubation.Results There was no significant difference in operation time between group A and group B [（123.0±15.2） minutes vs（125.0±12.1） minutes,P0.05].Compared with group B,SBP,DBP and HR obviously decreased in group A before extubation,during extubation,and 5 and 10 minutes after extubation（P0.05 or P0.01）.There were no significant differences in SpO2,time of eye opening and extubation time between the two groups（P0.05）.Compared with group B,the incidence of postoperative restlessness（1-3 grade） obviously decreased in group A（P0.05 or P0.01）.Conclusion Intravenous infusion of 0.5 μg·kg-1 dexmedetomidine at 30 minutes before the end of operation can effectively reduce cardiovascular responses to tracheal extubation,stabilize the hemodynamic status,and decrease the incidence of postoperative restlessness in patients with hypertension.

关 键 词：高血压 右美托咪定 气管拔管 血流动力学 躁动 术后 

分 类 号：R614.2[医药卫生—麻醉学] R97[医药卫生—外科学]