右美托咪定对心脏手术麻醉诱导期间血流动力学的影响  

Effect of dexmedetomidine on hemodynamics during induction of anesthesia in cardiac surgery

作　　者：张俊峰 

机构地区：[1]云南省普洱市人民医院,云南普洱665000

出　　处：《心血管病防治知识（学术版）》2014年第4期1-3,共3页Prevention and Treatment of Cardiovascular Disease

摘　　要：目的重点研究和探讨右美托咪定对心脏手术的麻醉效果以及麻醉诱导期间血流动力学的影响。方法利用回顾性分析的方法研究和比较对我院于2010年1月1日-2013年11月31日期间收治的114例行心脏手术麻醉患者的临床资料进行回顾性对照分析。将患者随机分为2组,均给予常规静脉麻醉,观察组总计57例在常规静脉麻醉的基础上静脉注射右美托咪定;对照组总计57例在常规静脉麻醉的基础上静脉注射与观察组等量的生理盐水。然后将2组数据结果进行分析,分析探讨两组患者麻醉效果以及麻醉诱导期间血流动力学的影响。结果通过对我院收治的114例行心脏手术麻醉患者的临床资料进行分析,两组患者在注药后5min时MAP值均明显下降,对照组下降幅度更大(P<0.05),在注药后10min、15min和30min时MAP值与基础值相比略有下降,但差异无显著性;对照组在注药后5min的HR值比基础值明显增快(P<0.05);SPO2两组差异无显著性(P>0.05)。观察组患者术后疼痛评分、清醒时间、呼吸恢复时间、阻滞完全时间、定向力恢复时间均好于对照组患者(P<0.05)。结论右美托咪定对心脏手术患者具有很好的麻醉效果,并且能够平稳血流动力学相关指标,目前已经成为行心脏手术静脉麻醉患者的主要药物,值得临床借鉴和进一步推广。Objective To investigate the anesthetic effect of dexmedetomidine in cardiac surgery and its effect on hemodynamics during induction of anesthesia. Methods A retrospective comparative analysis was performed on the clinical data of 114 patients who underwent anesthesia in cardiac surgery in our hospital from January 1, 2010 to November 31, 2013. These patients were randomly divided into observation group （n=57） and control group （n=57）. Both groups received routine intravenous anesthesia; in addition, the observation group was intravenously injected with dexmedetomidine, while the control group was intravenously injected with an equal volume of normal saline. The obtained data were analyzed to compare the anesthetic effect and hemodynamics during induction of anesthesia between the two groups. Results At 5 min after injection, both groups had significantly decreased mean arterial pressure （MAP）, but the control group had a significantly higher decrease （P〈0.05）. At 10, 15, and 30 min after injection, the MAP decreased nonsignificantly compared with the baseline value. At 5 min after injection, the heart rate of control group increased significantly compared with the baseline value （P〈0.05）. There was no significant difference in blood oxygen saturation between the two groups （P〉0.05）. The observation group was superior to the control group in terms of postoperative pain score, time to awakening, time to respiratory recovery, time to complete block, and time to recovery of environmental interpretation （P〈0.05）. Conclusion Dexmedetomidine has good anesthetic effect in patients undergoing cardiac surgery and can stabilize hemodynamic indices. It has become the main agent for intravenous anesthesia in cardiac surgery and holds promise for clinical application.

关 键 词：右美托咪定 心脏手术 麻醉诱导期 血流动力学 静脉麻醉 

分 类 号：R614[医药卫生—麻醉学]