不同剂量右美托咪定对琥珀胆碱气管插管时眼内压的影响  

Effects of different dosage of dexmedetomidine on the intraocular pressure changes after succinylcholine administration and endotracheal intubation

作　　者：过伟[1] 张兆平[1] 房宁宁[2] 顾美蓉[1] 裘学[1] 姚敏[1] 

机构地区：[1]南京医科大学附属无锡市人民医院麻醉科,214023 [2]南京医科大学附属无锡市人民医院体检中心,214023

出　　处：《临床麻醉学杂志》2013年第1期19-21,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察不同剂量右美托咪定对琥珀胆碱气管插管引起的眼内压(IOP)升高的影响。方法选择ASAⅠ或Ⅱ级无眼部疾患的全麻患者60例,随机均分为三组:D1组和D2组,麻醉诱导前10min内分别静脉给予右美托咪定0.4、0.6μg/kg;C组,给予等量生理盐水。监测和记录给予右美托咪定前(基础值,T0)、给予右美托咪定后3min(T1)、麻醉诱导后30s(T2)、给予琥珀胆碱后30s(T3)、气管插管后1min(T4)、2min(T5)、4min(T6)和6min(T7)时的MAP、HR和IOP。结果给予右美托咪定后D2组有2例患者因出现低血压和心动过缓被排除本研究。与T0时比较,T1～T3时D1组和D2组IOP明显降低(P<0.05);C组T3～T7时IOP和T4～T7时MAP明显升高;T4～T6时HR明显增快(P<0.05)。与C组比较,T3～T7时D1、D2组IOP明显降低(P<0.05),T4～T7时D1、D2组MAP明显降低、HR明显减慢(P<0.05)。结论静脉给予右美托咪定0.4、0.6μg/kg可有效预防与琥珀胆碱和气管插管有关的IOP升高,但0.6μg/kg右美托咪定可引起明显的低血压和心动过缓。因此,建议术前应用0.4μg/kg右美托咪定预防IOP升高。Objective The aim of this study was to evaluate the effect of different dosage of dexmedetomidine on the intraocular pressure changes after succinylcholine administration and endotracheal intubation. Methods Sixty ASA Ⅰ or Ⅱ patients undergoing general anaesthesia for non-ophthalmic surgery were randomly allocated into three groups to receive 0.4 μg/kg dexmedetomidine （group D1）, 0.6 μg/kg dexmedetomidine （group 132） or normal saline （group C） over a period of 10 min before induction. IOP, HR and MAP were recorded before and 3 min after the premedication（T0, T1 ）, 30 s after induction （T2）, 30 s after suxamethonium injection（T3 ） and 1 min （T4）, 2 min（T5）, 4 min （T6） and 6 min （TT） after endotracheal intubation. Results Two patients in group D2 were exduded because of hypotension and bradycardia after receiving dexmedetomidine. In group D1 and D2, fall in IOP was observed at T1-T3 compared with To （P〈0.01）. In group C, IOP at T3-TT. MAP at T4-T7 and HR at T4-T6 increased signifieantly（P〈0.05）. Compared with group C, IOP at T3-T7 and MAP, HR at T4-T7 was significantly lower in group D1 and D2 （P〈0.01）. Conclusion Dexmedetomidine （0. 6μg/kg as well as 0. 4μg/kg） could effectively prevent rise of IOP associated with administration of suxamethonium and endotracheal intubation. However, the dosage of 0. 6μg/kg may cause significant hypotension. Thus dexmedetomidine 0. 4μg/kg may be preferred for prevention of rise in IOP.

关 键 词：右美托咪定 眼内压 琥珀胆碱 气管插管 

分 类 号：R614[医药卫生—麻醉学]