右美托咪啶对腹腔镜结肠癌切除术患者循环和呼吸的临床观察  

EFFECTS OF DEXMEDETOMIDINE ON CIRCULATION AND RESPIRATION IN PATIENTS UNDER LAPAROSCOPIC RESECTION OF COLONIC CANCER

作　　者：赖永东[1] 何荣芝[1] 

机构地区：[1]广州医学院第二附属医院,广东广州510260

出　　处：《现代医院》2014年第1期14-16,共3页Modern Hospitals

基　　金：广东省医学科研基金立项(编号:A2012264)

摘　　要：目的评估右美托咪啶在腹腔镜下结肠癌切除术患者全麻诱导期中的镇静效应及其对循环和呼吸的影响。方法 60例行结肠癌切除术择期手术成年人,随机分为2组,每组30例。诱导开始后分别在10 min内给予右美托咪啶0.05μg/kg(D组)和咪唑安定对照组0.2 mg/kg(M组)静脉泵注。随后再静注芬太尼、异丙酚、维库溴铵行气管插管。记录诱导前(T1)、诱导开始后10 min(T2)、插管前(T3)、插管后即刻(T4)的脉搏血氧饱和度(SpO2)、呼吸频率(RR)、心率(HR)、收缩压(SBP)和舒张压(DBP)。结果 T2时点D组Ramsay评分值明显大于M组,有统计学差异(p<0.05)。组间比较M组T2和T3时点心率明显高于D组(p<0.05)。与T1时比较,D组的SBP和DBP均显著下降(p<0.05),M组在T3时SBP和DBP显著下降(p<0.05)。结论右美托咪啶在结肠癌切除术患者全麻诱导中可减少气管插管血流动力学变化,提供良好的镇静效应。Objective To investigate the effects of dexmedetomidine on circulation and respiration in patients under laparoscopic resection of colonic cancer and to observe its sedative effect during induction of general anesthesia. Methods 60 patients receiving resection of colonic cancer were divided into 2 groups randomly with 20 pa- tients in every group. Dexmedetomidine 0. 05 ug/kg was given within 10 minutes following induction of general anes- thesia in patients of group D while midazolam 0. 2 mg/kg was given in patients of group M. tracheal intubation were performed after fentanyl, propofol and vecuronium were given to patients. Pulse saturation （ SPO2 ） , respiratory rate （RR）, heart rate（ HR）, systolic blood pressure（ SBP）, diastolic blood pressure（DBP） were recorded before induc- tion（ T~ ）, 10 minutes after induction （T2 ）, before tracheal intubation （T3 ）, the moment following intubation （T~）. Results sedative score of Ramsay was significantly bigger in group D at T2 than that in group M （p 〈 0. 05 ）. HR at T2 was higher than that at T3 in patients of group D （p 〈0. 05）. SBP and SDP were decreased significantly after in- duction of anesthesia in patients of group D （p 〈0.05）. SBP and SDP were reduced significantly at T3 in patients of group M （p 〈 0. 05 ）. Conclusion dexmedetomidine may enhance hemodynamic stability during tracheal intubation while giving good sedation for patients under resection of colonic caner.

关 键 词：右美托咪啶 结肠癌 循环 呼吸 

分 类 号：R971.2[医药卫生—药品]