预注右美托咪定对快速序贯诱导时插管条件的影响  

The effects of dexmedetomidine as a pre-anesthesia medication in rapid sequence induction

作　　者：谢珏[1] 夏江燕[1] 祝龙[2] 文亚洲[1] 尹宁[1] 

机构地区：[1]东南大学附属中大医院麻醉科,南京市210009 [2]东南大学附属中大医院外科学系,南京市210009

出　　处：《临床麻醉学杂志》2014年第12期1193-1195,共3页Journal of Clinical Anesthesiology

摘　　要：目的：观察快速序贯诱导（RSI）前预注右美托咪定对插管条件及血流动力学的影响。方法选择40例择期全麻妇科手术患者，年龄25～50岁，随机分为两组，每组20例。D 组诱导前泵注右美托咪定0.6μg／kg（10 min 泵完），C 组泵注等量生理盐水10 ml，泵注期间给予面罩高流量吸氧5 L／min；泵注完毕后实施 RSI。记录插管时间和喉镜暴露分级，以及泵注前及泵注后15 min 内每分钟的 MAP、HR、BIS、SpO2；检测 PaO2和 PaCO2。结果两组插管时间和喉镜暴露分级差异无统计学意义。插管后14、15 min，C 组 MAP 较 D 组明显下降，HR 明显增快（P＜0.05）。插管期间两组SpO2和 PaO2差异无统计学意义。D 组呛咳发生率明显低于 C 组（P＜0.05）。结论RSI 前预注右美托咪定0.6μg／kg 可以在不影响机体氧储备的前提下，减少插管时的血流动力学波动和插管时间。Objective To investigate the effects of dexmedetomidine on hemodynamics and tra-cheal intubation facility in general anesthetized patients.Methods Forty gynecological patients of se-lective operation under general anesthesia were randomly arranged into 2 groups：group D and group C.With high flow mask oxygen inhalation（5 L/min）,dexmedetomidine was intravenously pumped in-to the patients in group D at 0.6μg/kg in 10 minutes while in group C saline were given instead.Both groups were then proceeded with rapid sequence induction （RSI）immediately.The values of MAP, HR,PaO2 and PaCO2 were recorded every minute from pumping start till 15 minutes,the bucking, intubation time and glottis exposure were evaluated as well.Results No significant differences were found in intubation time or glottis exposure between these two groups.After tracheal intubation group D showed higher MAP value than group C at 14,15 minutes,and a lower HR value （P 〈0.05）.Even no significant differences were found in values of SpO2 and PaO2 ,the group D showed less bucking than the group C （P〈0.05）.Conclusion Dexmedetomidine administration at 0.6μg/kg in RSI can diminish the variation in hemodynamics and facilitate the tracheal intubation by less buc-king,but no affect the oxygen reserve.

关 键 词：右美托咪定 快速序贯诱导 气管插管 

分 类 号：R614[医药卫生—麻醉学]