右美托咪啶在鼻内镜手术中控制性降压的应用探讨  

Application of dexmedetomidine inducing controlled hypotension in functional endoscopic sinus surgery

作　　者：陈英[1] 马艳丽[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,450052

出　　处：《中国实用医刊》2013年第24期38-39,共2页Chinese Journal of Practical Medicine

摘　　要：目的 探讨右美托咪啶在鼻内镜手术中控制性降压的安全性及有效性.方法 将60例择期全麻鼻内镜手术患者随机分为两组,每组30例：右美托咪啶组（D组）、硝酸甘油组（N组）行控制性降压,维持平均动脉压（MAP）在60 ～70 mm Hg（1 mm Hg=0.133 kPa）.观察术中血流动力学变化、术野质量及术中出血量、尿量、不良反应.结果 两组患者术中MAP均能维持在目标范围,D组血流动力学较平稳,术野质量评分（SSFQ）优于N组（P＜0.05）,出血量较N组少（P＜0.05）,尿量较N组多（P＜0.05）.N组有2例术后躁动;所有患者均无术中知晓、呼吸抑制等.结论 在鼻内镜手术中应用右美托咪啶行控制性降压安全可行,不良反应更少.Objective To investigate the security and efficacy of dexmedetomide inducing controlled hypotension in functional endoscopic sinus surgery.Methods Sixty patients subjected to general anesthesia were divided into two groups：the nitroglycerin group（group N） and the dexmedetomidine group （group D）.The MAP was maintained at 60-70 mm Hg（1 mm Hg =0.133 kPa）.The quality of the surgical field was assessed and the HR,MAP was recorded during operation; Amount of bleeding,urine volume,and adverse raction were recorded.Results The MAP was maintained at 60-70 mm Hg in all patients.The quality of the surgical field was better in the group D;Rebound hypertension occurred in the group N when extubating,the MAP was still lower than the level of preinduction in group D.Amount of bleeding was fewer and amount of urine volume was more in the group D.There were two patients agitated after operation in the group N and there was no other postoperative complication in all patients.Conclusions Induced hypotension by dexmedetomidine is feasible and safe in the functional endoscopic sinus surgery.

关 键 词：右美托咪啶 控制性降压 鼻内镜手术 全身麻醉 硝酸甘油 

分 类 号：R614[医药卫生—麻醉学]