不同剂量右美托咪定对全麻插管期应激反应的影响  

EFFECTS OF DIFFERENT DOSES OF DEXMEDETOMIDINEON ON STRESS REFLECT TO ENDOTRACHAEL INTUBATION

作　　者：于铁莉[1] 岳文慧[1] 王金城[2] 宋有鑫[1] 李汝泓[1] 李艳[1] 张晓侠[1] 王志学[1] 

机构地区：[1]承德医学院附属医院麻醉科,河北省承德市067000 [2]河北医科大学第三医院麻醉科

出　　处：《中国煤炭工业医学杂志》2014年第8期1235-1238,共4页Chinese Journal of Coal Industry Medicine

基　　金：2014年承德市科学技术研究与发展计划(编号:20142073)

摘　　要：目的观察不同剂量右美托咪定在全麻插管期应激反应的影响。方法选择90例择期行胃癌根治术的患者,随机分为三组,每组各30例。中剂量组(D1组)给予右美托咪定0.5μg/kg;高剂量组(D2组)给予0.8μg/kg;C组给予等量的生理盐水。以上各组药物均于麻醉诱导前10min内用微量泵输入。记录三组患者:入室时(给予右美托咪定前)(T0)、气管插管前(T1)、气管插管毕即刻(T2)、切皮前(T3)各时点心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、血浆皮质醇(Cor)和血糖(Glu)浓度。记录不良反应如:高血压、心动过缓、寒颤等的例数。结果 T2时点C组HR、SBP、DBP、MAP明显高于D1、D2组(P<0.05);T3时点C组的Cor、Clu浓度高于D1、D2组(P<0.05)。组内比较:C组各时点血流动力学波动明显(P<0.05),而D1、D2组波动不大(P>0.05)。不良反应例数D2组明显多于D1组。结论中剂量右美托咪定抑制气管插管引起的应激反应更安全有效。Objective To observe the effects of different doses of dexmedetomidineon on stress reflect to endotrachael intubation. Methods Totally 90 patients undergo radical operation for gastric cancer were subjected. They were randomly divided into three groups, 30 cases in each group. Median dose dexmedetomidine group（group D1）were given 0. 5ug/kg, and 0. 8ug/kg for the high dose dexmedetomidine group （group D2）, while group C was offered the same amount of physiological saline. The above liquid was all pumped within 10rain before endotrachael intubation. The parameters of heart rate （ HR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP） and mean arterial pressure （MAP） were recorded in the following time： just entering operating room （before Dex be given） （To ）; immediately before intubation （T1） ; immediately afert intubation （Ta ） ; before cut the skin（Ta ）. The palsma corticosteroid （Cor） and glucose （ Glu） of the arterial blood were measured. Adverse reactions were recorded such as hypertension, bradycardia, chill and so on. Results Group C compared with group D1 and 192 of hemodynamic had obvi- ously statistical differences at the time of Tz （P〈0.05）, and Cor and Glu in group C were higher than group D1 and D2 at T3 time（P〈0.05）; Comparison within groups： the comparison of hemodynamic had obviously differences（P〈0.05） within group C in each time, but there was little changes between group D1 and I）2 （P〉O. 05）. The adverse reaction cases of group D2 were more than group D1. Conclusion Continuous infusion of middle dose of dexmedetomidine is the best on control the stress reflect for the patients undergoing general anesthesia of endotrachael intubation.

关 键 词：盐酸右美托咪定 血流动力学 应激反应 血糖 皮质醇 

分 类 号：R614.2[医药卫生—麻醉学]