右美托咪啶对非体外循环冠状动脉旁路移植术的影响  

Effects of dexmedetomidine on off-pump coronary artery bypass grafting

作　　者：卢子会[1] 黄长顺[1] 黄自生[1] 黄洁[1] 钱幸尔 王俊[1] 

机构地区：[1]浙江省宁波市第一医院麻醉科,315010

出　　处：《中华全科医学》2014年第4期525-527,共3页Chinese Journal of General Practice

摘　　要：目的观察右美托咪啶对非体外循环冠状动脉旁路移植手术(OPCABG)的影响。方法 36例OPCABG患者,随机分为2组:右美托咪啶组(Ⅰ组)和对照组(Ⅱ组),每组18例。Ⅱ组采用咪达唑仑、舒芬太尼、依托咪酯、罗库溴铵诱导麻醉,Ⅰ组在Ⅱ组的基础上给予右美托咪啶0.5μg/kg缓慢静注,之后右美托咪啶以0.4μg/(kg·h)速度微泵持续输注至手术结束。记录患者基础值(T0)、麻醉诱导后(T1)、插管后1 min(T2)、插管后5 min(T3)、手术开始(T4)、锯胸骨(T5)、关胸骨(T6)、手术结束(T7)时的平均动脉压(MAP)和心率(HR)。记录麻醉药物用量、术后患者睁眼时间、气管导管拔除时间。结果Ⅰ组与Ⅱ组比较,MAP、HR在T2、T3、T4、T5、T6各时点降低(P<0.05);异丙酚、舒芬太尼用量Ⅰ组比Ⅱ组明显减少(P<0.05);Ⅰ组患者睁眼、拔管时间短于Ⅱ组(P<0.05)。结论右美托咪啶应用于OPCABG手术,辅助麻醉效果较好,可以使患者的血流动力学较为稳定,进一步减少麻醉药物的用量,苏醒较快且平稳。Objective To observe effect of dexmedetomidine on off-pump coronary artery bypass grafting （OPCABG）. Methods 36 cases OPCABG were randomly divided into two groups：the dexmedetomidine group and control group. Group I received induction of anesthesia with midazolam 0.05 - 0.1 mg/kg, sufentanil 0.5 - 0.8 p,g/kg, etomidate 0.15 -0.3 mg/kg and rocnronium rromide 0.8 mg/kg. Group I received dexmedetomidine 0.5 pg/kg intravenously be- fore induction of anesthesia, then keeping 0.4 p,g/（ kg h） until the end of surgery based on the group lI. Group II re- ceived normal saline in the same manner. The mean arterial blood pressure（MAP） and heart rate（HR） in baseline（ T0）, after induction of anesthesia （ T1 ）, after intubation 1 min （ T2 ）, after intubation 5 min （ 3＂3 ）, the beginning of surgery （ 3＂4 ）, saw the sternum （ T5 ） , off the sternum （ T6 ） , surgery end （ T7 ） were recorded. The amounts of anesthetic drugs, postopera- tive eye opening, tracheal extubation time were recorded as well. Results MAP and HR in group decreased significant- ly than group II in 3＂2, T3, T4, I＂5, T6 time point （ P 〈 0.05 ）, Propofol and sufentanil dosage in group I were significantly reduced than group 11 （ P 〈 0.05 ）. Eyes opening time and extubation time in Group I were shorter than group II （ P 〈 0.05 ）. Conclusion Dexmedetomidine might stabilize hemodynamics, reduce the dose of narcotic drugs and revive quick- ly and smoothly used in OPCABG surgery auxiliary anesthesia.

关 键 词：右美托咪啶 冠状动脉旁路移植术 非体外循环 麻醉 快通道 

分 类 号：R614.24[医药卫生—麻醉学] R654.2[医药卫生—外科学]