右美托咪定改善成人单肺通气时异丙酚-芬太尼平衡麻醉中的氧合功能  

Dexmedetomidine improves oxygenation during one-lung ventilation in balanced anesthesia with propofol-fentanyl in adults

作　　者：来勇[1] 李雅兰[1] 刘育勇[1] 彭雪梅[1] 王昊[1] 邹鹏[1] 

机构地区：[1]暨南大学附属第一医院麻醉科,广东广州510630

出　　处：《南方医科大学学报》2013年第7期1087-1090,共4页Journal of Southern Medical University

摘　　要：目的探讨联合使用右美托咪定对异丙酚-芬太尼平衡麻醉患者单肺通气状态下氧合功能的影响。方法 22例择期行胸腔镜手术患者随机分成研究组和对照组,采用基于异丙酚-芬太尼平衡麻醉,研究组加入右美托咪定泵注(0.3μg/kg负荷剂量,0.3μg(/kg.h)维持剂量),对照组使用生理盐水。麻醉过程中采集每位患者4个时点动脉血样进行血气分析,比较两组患者血气指标差异。结果研究组术中pH值维持稳定,氧合指数有进行性下降趋势,低氧血症发生率较低;对照组pH、氧合指数有进行性下降趋势,低氧血症发生率较高。结论联合使用右美托咪啶,能较好维持异丙酚-芬太尼平衡麻醉状态下单肺通气患者的氧合功能,其机制可能与降低异丙酚用量有关。Objective To investigate the effect of dexmedetomidine on oxygenation function in adult patients with balanced anesthesia by propofol- fentanyl under one- lung ventilation （OLV）. Methods Twenty- two patients undergoing thoracic operation were randomly divided into the study group and control group, both receiving propofol and fentanyl balanced anesthesia. In the study group, additional infusion of dexmedetomidine （0.3 μg/kg loading dose, 0.3 μg. kg - 1 . h - 1 maintenance dose） was administered, and the patients in the control group received only normal saline. Arterial blood samples were obtained at 4 time points from each patient during anesthesia for blood gas analysis. Results In the study group, the pH values remained stable, the oxygenation index tended to decline progressively, but the incidence of hypoxemia was low; in the control group, the pH value and oxygenation index both declined progressively with a higher incidence of hypoxemia. Conclusion Dexmedetomidine can better maintain the oxygenation function of OLV patients in balanced anesthesia by propofol and fentanyl, and its mechanism may be related to the decreased dose of propofol used.

关 键 词：右美托咪定 单肺通气 氧合 平衡麻醉 异丙酚 芬太尼 

分 类 号：R614[医药卫生—麻醉学]