不同全身麻醉下麻黄碱升压效应的比较  

Comparison of pressor responses to ephedrine during general anesthesia with different drugs

作　　者：夏江燕[1] 孙永瀛[2] 袁静[1] 陆新建[1] 汤文浩[3] 尹宁[1] 

机构地区：[1]210009南京市,东南大学附属中大医院麻醉科 [2]210009南京市,东南大学附属中大医院口腔科 [3]210009南京市,东南大学附属中大医院普外科

出　　处：《中华麻醉学杂志》2013年第9期1037-1039,共3页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金（81201449/H1502）;东南大学医学院青年基金（QJ2012010）

摘　　要：目的 比较不同全身麻醉下麻黄碱的升压效应.方法 择期胃肠道肿瘤切除术患者60例,年龄20 ～ 64岁,体重45 ～ 90 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其分为3组（n=20）,Ⅰ组：右美托咪定-瑞芬太尼-七氟醚复合麻醉；Ⅱ组：异丙酚-瑞芬太尼-七氟醚复合麻醉；Ⅲ组：右美托咪定-异丙酚-瑞芬太尼-七氟醚复合麻醉.麻醉中SBP降至90 mm Hg左右时静脉注射麻黄碱0.1mg/kg,给药后10 min内每分钟测定血压,记录麻黄碱升高SBP、DBP和MAP的起效时间（TSBP、TDBP、TMAP）及其最大幅度（△SBP、△DBP、△MAP）.结果 与Ⅱ组比较,Ⅰ组和Ⅲ组TSBP、TDBP、TMAP缩短,△SBP、△DBP、△MAP增大（P＜0.05）.结论与异丙酚-瑞芬太尼-七氟醚复合麻醉相比,右美托咪定-瑞芬太尼-七氟醚复合麻醉和右美托咪定-异丙酚-瑞芬太尼-七氟醚复合麻醉下麻黄碱升压效应增强.Objective To compare the pressor responses to ephedrine during general anesthesia with different drugs.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,scheduled for elective gastrointestinal tumor resection under general anesthesia,aged 20-64 yr,weighing 45-90 kg,were included in this study.The patients were randomized to receive dexmedetomidine ＋ remifentanil ＋ sevoflurane （group Ⅰ,n =20）,propofol ＋ remifentanil ＋ sevoflurane （group Ⅱ,n =20）,or dexmedetomidine ＋ propofol ＋ remifentanil ＋ sevoflurane （group Ⅲ,n =20） to maintain the depth of anesthesia.Ephedrine 0.1 mg/kg was injected intravenously when the systolic blood pressure （SBP） was decreased to about 90 mm Hg during anesthesia.Blood pressure was monitored and recorded at 1-min intervals for 10 min after the injection.The onset time （TSBP,TDBP,TMAP） for ephedrine to raise the SBP,diastolic blood pressure （DBP） and mean arterial pressure （MAP） and the maximal amplitude （△SBP,△DBP,△MAP） were also recorded.Results Compared with Ⅱ group,TSBP,TDBP and TMAP were significantly shortened,and △SBP,△DBP and △MAP were increased in Ⅰ and Ⅲ groups （P 〈 0.05）.Conclusion Compared with propofol ＋ remifentanil ＋ sevoflurane combined anesthesia,dexmedetomidine ＋ remifentanil ＋ sevoflurane combined anesthesia and dexmedetomidine ＋ propofol ＋ remifentanil ＋ sevoflurane combined anesthesia augment the pressor responses to ephedrine in patients. Keywords：Anesthetics, General; Ephedrine ; Blood Pressure

关 键 词：麻醉药 全身 麻黄碱 血压 

分 类 号：R614[医药卫生—麻醉学]