右美托咪定对腹腔镜手术七氟醚用药量的影响  

Effects of Dexmedetomidine on Sevoflurane Consumption in Patients Undergoing Laparoscopic Surgery

作　　者：赵晓春[1] 佟冬怡[1] 龙波[1] 池晓颖[1] 张立民[1] 吴秀英[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳110004

出　　处：《中国医科大学学报》2014年第2期110-113,共4页Journal of China Medical University

基　　金：国家自然科学基金(81000824)

摘　　要：目的观察2种不同剂量右美托咪定（Dex）对妇科腹腔镜手术患者全麻吸入七氟醚浓度及血流动力学的影响。方法选择择期行妇科腹腔镜手术的患者90例，随机分成对照组（c组）、低剂量（0．4μg／kg）Dex组（L组）和高剂量（0．8μg／kg）Dex组（H组），每组30例。L组和H组患者分别于置入喉罩后静脉输注Dex0．4μg／kg和0．8μg／kg；C组患者于置入喉罩后静脉输注同等容量的生理盐水。3组药物均以微量泵在30min内泵注完毕。术中维持脑电双频指数（BIS）在45—55，分别于输注Dex前（T0）、输注Dex10min后（T1）、气腹即刻（T2）、气腹后30min（T3）、气腹结束即刻（T4）记录患者吸入七氟醚浓度、收缩压（SBP）、舒张压（DBP）和心率（HR）。记录苏醒时间及嗜睡、心动过缓、低血压等不良反应的发生情况。结果气腹过程中L组和H组七氟醚吸入浓度均明显低于C组（P〈0．05），H组明显低于L组（P〈0．05）；与C组比较，H组和L组气腹即刻及气腹过程中SBP、DBP和HR均明显降低；H组较L组苏醒时间、术中心动过缓、低血压及术后嗜睡不良反应的发生率无统计学差异。结论本观察所用剂量Dex可明显降低妇科腹腔镜全麻七氟醚吸入麻醉时的浓度，有效节约全麻术中七氟醚的用量，血流动力学稳定，不影响苏醒。Objective To investigate the effects of two doses of dexmedetomidine （Dex） on sevoflurane concentration with remifentanil and hemo- dynamics during gynecological laparoscopic surgery. Methods Ninety patients during laparoscopic surgery who received general anesthesia were randomly divided into three groups ： group C received a saline infusion after anesthesia induction, group L received Dex 0.4μg/kg and group H re- eeived Dex 0.8 μg/kg.The sevoflurane concentration was adjusted to maintain BIS within 45-55. HR, SBP, DBP and sevoflurane concentration were continuously monitored. SBP, DBP and HR were recorded before the infusion of dexmedetomidine （T0）, 10 minutes after the infusion of Dex （T1）, after the pneumoperitoneum （T2）, 30 minutes after the pneumoperitoneum （T3）, and at the time of de -pneumoperitoneum （T4）. Recovery time and adverse reactions were also recorded. Results The sevollurane concentrations of group L and group H were lower than that of group C （P 〈 0.05 ）, and the sevoflurane concentration of group H was lower than that of group L （P 〈 0.05 ）. Compared with group C, HR, SBP and DBP were significant- ly decreased at T2, T3 and T4 in groups L and H. There was no significant difference between group L and H in waking time and adverse effects （P 〉 0.05 ）. Conclusion Adjunctive use of Dex 0.4 and 0.8μg/kg could decrease the sevoflurane concentration, maintain hemodynamie stability during gynecological laparoscopie surgery, and has no severe adverse effects on waking time.

关 键 词：右美托咪定 腹腔镜 七氟醚 吸入浓度 血流动力学 

分 类 号：R71[医药卫生—妇产科学]