不同剂量右美托咪定对颅内动脉瘤夹闭术患者围术期血流动力学的影响  

Effects of Pretreatment with Different Doses of Dexmedetomidine on Hemodynamics during Intracranial Aneurysm Clipping

作　　者：李雪婷[1] 马超群[2] 贺振秋[1] 谢宇颖[1] 韩力强[2] 

机构地区：[1]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150001 [2]哈尔滨二四二医院,黑龙江哈尔滨150066

出　　处：《现代生物医学进展》2014年第32期6284-6287,共4页Progress in Modern Biomedicine

基　　金：黑龙江省卫生厅科研课题(2010149)

摘　　要：目的:观察单次给予不同剂量的右美托咪定对开颅行颅内动脉瘤夹闭手术的患者围术期血流动力学的影响,为右美托咪定在临床上的合理应用提供一定的理论基础。方法:选择拟行开颅颅内动脉瘤夹闭术的患者80例,年龄30-65岁,ASA I-III级,随机分为4组:Dl组、D2组、D3组和N组(生理盐水对照组),每组各20例。在麻醉诱导前20 min,四组患者分别经外周静脉泵注0.4μg·kg-1右美托咪定20 mL、0.8μg·kg-1右美托咪定20 mL、1.2μg·kg-1右美托咪定20 mL及生理盐水20 mL,每组的输注时间均为20 min。记录四组患者在麻醉和手术期间不同时点的平均动脉压(MAP)和心率(HR)的变化。结果:D2组的心率和血压与基础值相比波动较小,血流动力学更平稳。D1组和D3组的血压和心率较D2组波动明显。D3组的拔管时间明显较D1组、D2组和N组的时间延长(P<0.05)。结论:0.8μg·kg-1右美托咪定用于颅内动脉瘤夹闭手术有利于维持患者麻醉和手术期间血流动力学的稳定,且不增加不良反应。Objective： To observe the effects of intravenous pretreatment with different doses of dexmedetomidine on hemodynamics during intracranial aneurysm clipping, and provide references for the reasonable clinical application of dexmedetomidine. Methods： Eighty cases of patients with the general anesthesia undergoing intracranial aneurysm clipping were selected. They were 30-65 years old, and ASA classification was I or III level. All the patients were randomly divided into four groups （20 cases in each group）： group D1, group D2, group D3 and group N. Before induction of anesthesia, patients in group N were injected with saline 20 mL; patients in group D1, D2 and D3 were given an intravenous infusion of 0.4, 0.8 and 1.2 μg ·kg^-1 dexrnedetomidine 20 mL, respectively. The infusion time for each group was 20 min. The blood pressure and the heart rate at different time points were recorded and compared between different groups. Results： Compared with group D1 and group D3, the blood pressure and heart rate in group D2 were more stable. The extubation time of group D3 was significantly longer than the other three groups. Conclusion： The use of 0.8 μg ·kg^-1 dexmedetomidine hydrochloride could stabilize the hemodynamics of patients with intracranial aneurysm clipping during anesthesia and surgery, and wouldn＇t increase the adverse reactions.

关 键 词：右美托咪定 颅内动脉瘤 血流动力学 围术期 

分 类 号：R739.41[医药卫生—肿瘤] R614[医药卫生—临床医学]