右美托咪啶联合芬太尼对七氟醚麻醉诱导患者的影响  

Effects of dexmedetomidine combined with fentanyl in patients undergoing anesthesia induction by sevoflurane

作　　者：冯翠[1] 戚思华[1] 邹玉梅[1] 马雪松[1] 高大鹏[1] 韩宝庆[1] 

机构地区：[1]哈尔滨医科大学附属第四医院麻醉科,哈尔滨150001

出　　处：《中华医学杂志》2012年第27期1889-1891,共3页National Medical Journal of China

基　　金：黑龙江省教育厅科学技术研究项目（11551206）

摘　　要：目的探讨右美托咪啶（Dex）联合芬太尼对七氟醚麻醉诱导的影响。方法选择2011年4—9月哈尔滨医科大学附属第四医院麻醉科择期全身麻醉气管插管手术患者80例，经医院伦理委员会审核通过，患者知情同意，数字表随机双盲分成Dex联合芬太尼组（DF组）和芬太尼组（F组），每组40例。DF组于麻醉诱导前10min静脉泵入0．5μg／kg的Dex，F组给予等量生理盐水；潮气量法麻醉诱导，两组都给予2μg／kg芬太尼和0．1mg／kg维库溴铵气管插管。观察麻醉诱导前（T0）、气管插管前（T1）、气管插管即刻（T2）、气管插管后1（T3）、3（T4）、5rain（T5）平均动脉压（MAP）和心率及不良反应。结果DF组睫毛反射消失时间短于F组（P〈0．05），不良反应少于F组（P〈0．05），追加阿托品例数高于F组（P〈0．05）。DF组诱导后各时刻的MAP都低于T0时刻（P〈0．05）；F组诱导后T1、T3、T4、T5，时刻MAP低于T0时刻（P〈0．05），且T1时刻MAP低于T2、T3和DF组（P〈0．05）。DF组诱导后各时刻的HR低于T0时刻和F组（P〈0．05），且T1时刻心率低于T2、T4（P〈0．05）；F组T1时刻心率低于T2、T3时刻（P〈0．05）。结论右美托咪啶联合芬太尼可以更好地抑制七氟醚诱导插管的应激反应，稳定血流动力学。Objective To investigate the effects of dexmedetomidine combined with fentanyl in patients undergoing anesthesia induction by sevoflurane. Method Eighty patients for elective endotracheal intubation under general anesthesia operations were randomly and double-blindly divided into Dex combined with fentanyl group （Group DF） and the fentanyl group （Group F） from April 2011 to September 2011 at the Fourth Affiliated Hospital of Harbin Medical University , and there were 40 cases in each group. The investigation was approved by all the patients and by the Ethics Committee of the hospital. In group DF, each patient was pumped in the 0. 5 ~g/kg Dex by vein befor 10 minutes of anesthesia induction and group F were given the same amount of normal saline, and tidal volume method was used to induce anesthesia of sevoflurane. All the patients were given 2 μg/kg fentanyl and 0. 1 mg/kg vecuronium by tracheal intubation and the MAP and HR and adverse reactions were observed before anesthesia induction （T0 ）, before endotracheal intubation （ T1 ）, at the moment of tracheal intubation （ T2 ）, after 1 minutes of tracheal intubation （T3 ）, after 3 minutes of tracheal intubation （ T4 ） and after 5 minutes of tracheal intubation （ T5 ）. Result The loss of eyelash reflex time of group DF is shorter （ P 〈 0. 05 ）, adverse reaction is less （ P 〈 0. 05 ） and the number of adding atropine case is higher than that of group F （ P 〈 0. 05 ）, the MAP of the two groups after induction of other moments are lower than that of To （P 〈 0. 05） ; MAP of group F at T1 is lower than that of T0, T2 ,T3 and group DF （P 〈0. 05）; T1 of group DF is lower than that of T0（P 〈 0. 05） ,the HR after induction of group DF is lower than that of To and F group （P 〈0.05） ,and that of T2 and T4 are higher than that of T1（P〈0.05）; HR of group F at T1 is lower than that of T2 and T3 （P 〈0. 05）. Conclusion Dexmedetomidine in combination with fentanyl can inhibit stress response of

关 键 词：右美托咪啶 麻醉药 吸入 芬太尼 血流动力学 

分 类 号：R614[医药卫生—麻醉学]