小剂量右美托咪定在腹腔镜妇科手术中的应用  

Effect of Small Dose of Dexmedetomidine as General Anesthesia Adjuvant in Patients Undergoing Gynecological Laparoscopy

作　　者：金建华[1] 陈亚萍[1] 刘伟[1] 唐俊[1] 

机构地区：[1]复旦大学附属金山医院,上海200540

出　　处：《中国肿瘤》2013年第8期676-679,共4页China Cancer

摘　　要：[目的]观察小剂量右美托咪定对腹腔镜妇科手术中的血流动力学和镇静镇痛药物用量的影响。[方法]选择全麻下行腹腔镜妇科手术的患者60例,美国麻醉医师协会(ASA)分级为Ⅰ～Ⅱ级,随机分为右美托咪定组(D组)和对照组(C组),每组各30例。记录诱导前(T0)、诱导后(T1)、插管后即刻(T2)、插管后10min(T3)、插管后30min(T4)和插管后50min(T5)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率(HR)。记录两组维持相同麻醉深度的丙泊酚、舒芬太尼和顺式阿曲库铵用量及不良反应发生情况。[结果]D组T3和T4的SBP、DBP、MAP均低于C组(P<0.05)。D组T3和T4的HR低于C组(P<0.01)。D组患者丙泊酚和舒芬太尼用量明显少于C组(P<0.01)。D组不良反应的发生率与C组无明显差别。[结论]小剂量右美托咪定能稳定腹腔镜妇科手术术中的血流动力学,减少镇静镇痛药物用量,不良反应少。[Purpose] To study the effect of small dose of dexmedetomidine as general anesthesia adjuvant in patients undergoing gynecological laparoscopy. [Methods] Sixty cases undergoing gynecological laparoscopy were randomly divided into two groups： dexmedetomidine group（Group D） and control group（Group C）. Systolic pressure（SBP）,diastolic pressure（DBP）,mean arterial pressure（MAP） and heart rate（HR） were recorded before induction（T0）,after induction（T1）,during intubation（T2）,10min（T3）,30min（T4）,and 50min（T5） after intubation. The consumption of propofol,sufentanil,cisatracurium and the incidences of adverse effects were observed. [Results] SBP,DBP and MAP at T3 and T4 in group D were lower than those in group C（P0.05）. HR at T3 and T4 in group D were significantly lesser than that in group C （P0.01）. The consumption of propofol and sufentanil in group D were lower than those in group C（P0.01）. There was no significant difference on the incidences of adverse effects between two groups. [Conclusion] As a general anesthetic adjuvant,small dose of dexmedetomidine may keep stable perioperative hemodynamics,reduce propofol and sufentanil requirements and minimize the adverse effects.

关 键 词：右美托咪定 腹腔镜妇科手术 血流动力学 丙泊酚 舒芬太尼 

分 类 号：R713[医药卫生—妇产科学]