盐酸右美托咪定对硬膜外复合全麻诱导期血流动力学的影响  

The effect of Dexmedetomidine on induction period of hemodynamics in patients undergoing general anesthesia combined with epidural block

作　　者：陶学有[1] 李晓明[1] 宁妮[1] 翟海霞[1] 左美娟[1] 

机构地区：[1]扬州大学医学院附属扬州市妇幼保健院麻醉科,江苏扬州225001

出　　处：《实用临床医药杂志》2014年第5期125-126,132,共3页Journal of Clinical Medicine in Practice

摘　　要：目的盐酸右美托咪定对硬膜外复合全麻下妇科手术全麻诱导期血流动力学的影响。方法选择本院择期妇科全子宫切除术40例（ASAⅠ～Ⅱ级），随机分为盐酸右美托咪定组（D组）20例和丙泊酚组（P组）20例，D组行连续硬膜外麻醉，0．5μg／（kg·h）持续输注，待麻醉平面确定后全麻诱导气管插管；丙P组除不给予盐酸右美托咪定，其他各项与D组相同。记录人室后（T1），硬膜外麻醉平面确定后（T2），全麻诱导前（T3），气管插管前即刻（T4），气管插管后即刻（T5）和手术开始时（T6）时患者的收缩压（SBP），舒张压（DBP），平均动脉压（MAP），心率（HR）及氧饱和度（SpO2）。结果T1时间点2组各指标均无差别（P〉0．05）。D组与P组比较，其余各时间点的HR均低于P组（P〈0．05），T5和T6时间点SBP、DBP、MAP低于同时点P组（P〈0．05），T2、T3和T4SBP、DBP、MAP高于同时点P组（P〈0．05）。结论盐酸右美托咪定应用于连续硬膜外复合全麻患者，在全麻诱导期患者血流动力学更加稳定。Objective To observe the effect of Dexmedetomidine （DEX） on induction period of hemodynamics in patients undergoing general anesthesia combined with epidural block. Methods A total of 40 hysterectomy patients in optional period （ASA Ⅰ- Ⅱ ） were randomly divided into Dexmedetomidine group（Group D） and Propofol group（P group）. Group D received continuous epidural anesthesia with infusion of DEX 0.5 μg/（kg· h） and endotracheal intubation was applied after general anesthesia. Group P was given the same therapy with group D except dexmedetomidine. HR, SBP, DBP and MAP of the hemodynamic index were recorded at the time of entering the operation room（T1 ）, after the determination of epidural plane（T2）, preintubation（T3）, intubation（T4）, immediately after trachea intubation（T4）, and the beginning of operation（T4）. Results The difference was not statistically significant in the index between the two groups at T1. HR of group D was lower than that in group P at alltime points（P〈0.05）. SBP, DBP and MAP of group D were higher than group P at T2, T3 and T4 （P 〈 0.05）. SBP, DBP, MAP of group D were lower than group P at T5 and T6 （P 〈 0.05）. SBP,DBP and MAP in group D at T2, T3 and T4 were higher than that in the group P （P 〈 0.05）. Conelusion Dexmedetomidine can offer a stable hemodynamics in the patients with general anesthesia combined with epidural block.

关 键 词：盐酸右美托咪定 硬膜外 全麻 血流动力学 

分 类 号：R614[医药卫生—麻醉学]