右美托咪定手术结束前滴鼻对全麻苏醒期应激反应的影响  

Effect of intranasal dexmedetomidine before the end of operation on stress response during recovery period of general anesthesia

作　　者：卢燕[1] 何绮霞[1] 莫坚[1] 庄海霞[1] 陈翠平[1] 张良清[1] 

机构地区：[1]广东医学院附属医院麻醉科,湛江市524001

出　　处：《实用医学杂志》2015年第3期458-459,共2页The Journal of Practical Medicine

基　　金：广东省自然科学基金联合资助项目(编号:S2011040005514)

摘　　要：目的：观察右美托咪定手术结束前滴鼻对全麻苏醒期应激反应的影响。方法：60例ASAⅠ或Ⅱ级择期行腹腔镜阑尾切除手术患者平均分为右美托咪定组（D组）和对照组（C组）。D组手术结束前30 min给予右美托咪定0.5μg/kg滴鼻;C组等量生理盐水滴鼻。记录两组患者苏醒时间、拔管时间,手术结束前30min（T1）、手术结束时（T2）、气管导管拔管时（T3）、气管导管拔管后30 min（T4）MAP、HR,并留T1~T4时静脉血,检测血中去甲肾上腺素（NE）、肾上腺素（E）的水平变化。结果：两组患者苏醒时间、拔管时间差异无统计学意义;与C组比较,T2、T3、T4时D组MAP降低,HR减慢,NE、E降低（P〈0.05）。结论：手术结束前右美托咪定滴鼻能明显抑制全麻苏醒期应激反应,有利于血流动力学的稳定,并且不影响患者苏醒时间。Objective To observe the effect of intranasal dexmedetomidine 30 min before the end of operation on stress response during recovery period of general anesthesia. Methods 60 patients with ASA Ⅰ or Ⅱ un- dergoing elective resection of laparoscopic appendectomy were randomily devided into dexmedetomidine group （group D） and control group （group C） with 60 cases each. Patients in group D received intranasal dexmedetomi- dine 0.5 μg/kg 30 min before the end of operation, while group C received the same volume of normal saline. The recovery time and extubation time were recorded. The mean arterial pressure（MAP）, heart rate（HR） were recorded at 30 min before the end of operation （T1）, immediate end of operation （T2）, extubation（T3） and 30 min after extubation （T4）. Norepinephrine（NE）, epinephrine（E） levels were detected at T1-T4 in both groups. Results Compared with group C, the recovery time and extubation time were no significantly differences, MAP and HR in group D were significantly lower at T2, T3 and T4（P 〈 0.05）, the norepinephrine（NE）, epinephrine（E） in group D was significantly lower at T2, T3 and T4（P 〈 0.05）. Conclusion Intranasal dexmedetomidine can inhibit stress response during recovery period of general anesthesia, and it is benbficial to hemodynamic stability.

关 键 词：右美托咪定 滴鼻 苏醒期 应激反应 

分 类 号：R614[医药卫生—麻醉学]