右美托咪定对脊柱侧弯矫形术患者全麻诱导和术中唤醒时血流动力学的影响  

Effects of dexmedetomidine on hemodynamics during anesthesia induction and intraoperative wake-up in patients undergoing scoliosis surgery

作　　者：李勇[1] 胡丽君[1] 马正良[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,210008

出　　处：《临床麻醉学杂志》2011年第12期1185-1187,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察右美托咪定对脊柱侧弯矫形术患者全麻诱导和术中唤醒时血流动力学的影响。方法择期行脊柱侧弯后路矫形手术患者40例,随机均分为右美托咪定组(D组)和生理盐水组(C组),分别在麻醉诱导前给予0.8μg/kg右美托咪定和等量生理盐水,10min内输完。术中D组持续泵入右美托咪定0.2μg·kg-1·h-1,C组泵入生理盐水。观察麻醉诱导前10min(T0)、麻醉诱导后3min(T1)、气管插管后1min(T2)、3min(T3)以及唤醒开始前即刻(T6)、唤醒试验开始后10min(T5)、15min(T6)、唤醒时(T7)的SBP、DBP、HR。记录唤醒时间及唤醒期间的出血量。结果与T0时比较,T1时两组SBP、DBP显著降低,HR显著减慢(P<0.05),且D组显著高/慢于C组(P<0.05)。T2、T3时D组HR明显慢于C组(P<0.05)。T6、T7时D组SBP、DBP显著低于C组,HR明显慢于C组(P<0.05)。唤醒期间D组出血量显著少于C组(P<0.01)。结论右美托咪定有助于脊柱侧弯矫形手术患者全麻诱导及术中唤醒时血流动力学的稳定,减少唤醒期间出血,不影响唤醒时间,具有较好的保护效应。Objective To investigate effects of dexmedetomidine （DEX） on hemodynamics during anesthesia induction and intraoperative wake-up in patients undergoing scoliosis surgery. Methods Forty patients undergoing elective posterior scoliosis surgery were randomly divided into the group D and C （n=20 each）. DEX 0. 8 μg/kg followed by 0. 2 μg.kg- 1 .h- 1 and equal volume NS were infused respectively 10min before anesthesia induction in two groups. Hemodynamic parameters were observed 10 rain before anesthesia induction （To）, 3 min （T1） after anesthesia induction, 1 min （T2）, 3 min（T3 ） after intubation, at the beginning of wake-up test （T4）, 10 min （T5）, 15min（T6 ） later and at the end （T7） of the test respectively. Meanwhile the wake up time and the bleeding volume during the test were also recorded. Results SBP, DBP and HR were decrease at T1 compared with T0, which was more significant in group C（P〈0.05）. HR at T2 and T3 in group D were lower than that in group C（P〈0. 05）. SBP and DBP were lower at T6 and T7 in group D than that in group C（P〈0. 05）. The bleeding volume during the test was less in group D（P〈0. 01）. Conclusion Dexmedetomidine has protective effect on seoliosis surgery patients during general anesthesia induction and wake-up test.

关 键 词：右美托咪定 脊柱侧弯矫形术 术中唤醒 血流动力学 

分 类 号：R614[医药卫生—麻醉学]