右美托咪啶对鼻内镜手术围术期血流动力学的影响  

EFFECT OF DEXMEDETOMIDINE ON PERIOPERATIVE HEMODYNAMICS IN PATIENTS UNDERGOING FUNCTIONAL ENDOSCOPIC SINUS SURGERY

作　　者：谢汉镔[1] 刘德昭[1] 

机构地区：[1]中山大学第三医院,广东广州510630

出　　处：《现代医院》2014年第10期26-28,共3页Modern Hospitals

基　　金：广东省科技计划项目(编号:2011B31800058)

摘　　要：目的观察右美托咪啶对鼻内镜手术血流动力学的影响。方法选择我院择期行功能性鼻内镜手术(FESS)手术的患者60例,按照随机数字表法分为两组:右美托咪啶组(D组,n=30)和生理盐水对照组(P组,n=30)。D组患者在麻醉诱导插管前10 min静脉泵注右美托咪啶0.5 ug/kg,然后以0.4 ug/kg/h维持到手术结束;P组使用生理盐水以相同速度静脉泵注。比较两组围术期血流动力学变化和血管活性药物的用药总量;术野质量评分(Fromme评分);手术时间、拔管时间、复苏时间以及术后躁动的发生率。结果与生理盐水对照组比较:右美托咪啶组在气管插管后和手术医生使用肾上腺素后血流动力学更为稳定,血管活性药物的用量减少,围术期窦速的发生率明显降低,手术医师对术野质量Fromme评分则明显降低(均p<0.05)。结论右美托咪啶应用有利于FESS术中患者血流动力学的稳定,保持清晰的手术视野,并有利于麻醉复苏期的平稳过渡。Objective To investigate the effect of dexmedetomidine on perioperative hemodynamics in pa- tients undergoing functional endoscopic sinus surgery （FESS）. Method Sixty patients scheduled for FESS were di- vided into two groups with 30 patients in each group and control group （Physiological saline, group P ）. Before anes- thesia induction a loading dose of dexmedetomidine 0.5 μg/kg was injected intravenously, followed by infusion at 0.4 μg/kg/h until the end of operation in D group. The equal volume of normal saline was administered in C group. The hemodynamics changes, total dose of of vasoactive drugs, surgical field quality score （Fromme）, the operation time, recovery time and extubation time, incidence rate of postoperative agitation were compared. Result Compared with the C group, the hemodynamics was more stable after intubation and using adrenaline, and the dosage of vasoactive drugs, perioperative sinus tachycardia was significantly decreased, and Fromme score were obviously lower than that in D group （ all p 〈 0.05 ）. Conclusion Dexmedetomidine could help to keep the hemodynamics more stable in pa- tients with FESS, keeping clear surgical visual field, and is advantageous to to the smooth transition of anesthesia re- covery period.

关 键 词：右美托咪啶 鼻内镜 控制性降压 血流动力学 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]