右美托咪定对高血压病患者全麻气管插管时血流动力学的影响  

Effect of dexmedetomidine on hemodynamics in hypertensive patients during endotracheal intubation

作　　者：王显望[1] 刘峰[1] 王恒林[1] 徐震[1] 吕宝胜[1] 王卓强[1] 

机构地区：[1]解放军第309医院麻醉科,北京100091

出　　处：《心脏杂志》2014年第4期477-479,共3页Chinese Heart Journal

摘　　要：目的：观察右美托咪定对高血压患者全麻诱导气管插管时血流动力学影响。方法：选取40例需气管插管全麻手术的高血压病患者，随机分为试药组和对照组（每组20例），分别在麻醉诱导前10min泵入右美托咪定1μg／kg和生理盐水。记录给药前（基础值T0）、给药后（T1）、麻醉诱导后（T2）、插管后即刻（T3）、插管后3、5和10min（T4、T5、T6）时患者心率（HR）、收缩压（SBP）、舒张压（DBP）和脑电双频指数（BIS）的变化。记录麻醉诱导时丙泊酚的用量。结果：对照组T3、T4时HR、SBP和DBP均比Tn时显著升高（P〈0．05，P〈0．01）。试药组T3-T5时HR、SBP和DBP分别与T0时比较无显著差异。试药组T3、T4时HR、SBP和DBP显著低于对照组同一时间点（P〈0．05，P〈0．01）。试药组在T5时HR和SBP显著低于对照组同一时间点（P〈0．05）。诱导时试药组丙泊酚用量（113±22）mg显著低于对照组（140±25）mg（P〈0．01）。试药组T1时BIS值（73±4）显著低于C组（97±2）（P〈0．01）。结论：麻醉诱导前给予右美托咪啶1μg/kg能显著抑制气管插管时血流动力学反应，减少诱导时丙泊酚用量。AIM： To observe the effect of dexmedetomidine on hemodynamics in hypertensive patients during endotracheal intubation. METHODS： Forty hypertensive patients receiving tracheal intubation under general anaesthesia were randomly allocated into two groups （20 cases each）, and group D and group C, respectively, received dexmedetomidine （1 μg/kg） and saline. Heart rate （HR）, systolic arterial pressure （SAP）, diastolic arterial pressure （DAP） and bispectral index （BIS） were recorded, respectively anesthesia T6 ）. The , before drug administration （ baseline ; T0 ）, after drug administration （ T1 ）, after induction of （T2 ）, immediately after intubation （T3 ） and 3, 5 and 10 min after intubation （T4, T5, and dosages of propofol used during anesthesia induction were recorded. RESULTS ： In group C, HR, SBP and DBP at T3 and T4 were higher than those at TO （P 〈 0.05, P 〈 0. 01）. In group D, there were no significant differences in HR, SBP and DBP between at T3, T4, Ts, and at T0. At T3 and T4, HR, SBP and DBP in group D were lower than those in group C at the same time point （ P 〈 0. 05, P 〈 0. 01 ）. At T5, HR and SBP in group D were lower than those in group C （P 〈0. 05）. During anesthesia induction, the dosages of propofol in group D （113 ±22） mg were significantly lower than those in group C （ 140 ±25） mg （P 〈0. 01 ）. At T1, the value of BIS in group D （73±4） was significantly lower than that in group C （97 ± 2） （P 〈 0. 01 ）. CONCLUSION： Dexmedetomidine （ 1 μg/kg） given 10 rain before anesthesia induction significantly attenuates the hemodynamic response to tracheal intubation and reduces the dosages of propofol during anesthesia induction.

关 键 词：右关托咪定 全身麻醉 气管插管 血流动力学 

分 类 号：R971[医药卫生—药品]