右旋美托咪定在纤维支气管镜引导气管插管全麻甲状腺手术的应用  

Use of dexmedetomidine in intratracheal intubation with fiberoptic bronchoscope in thyroid surgeries under general anesthesia

作　　者：查鹏[1] 冯鲲鹏[2] 马艳辉[2] 张瑛[2] 李艳英[2] 刘广宇[2] 薛纪秀[2] 王天龙[2] 

机构地区：[1]海军总医院胸外科,北京100037 [2]首都医科大学宣武医院麻醉手术科,北京100053

出　　处：《中国新药杂志》2015年第4期434-438,共5页Chinese Journal of New Drugs

摘　　要：目的：研究右旋美托咪定（dexmedetomidine，Dex）对全麻甲状腺手术患者接受纤维支气管镜（fiberoptiebronchoscope，FOB）引导经口气管插管的影响。方法：拟行经口气管插管全麻甲状腺手术患者80例，美国麻醉医师协会（AmericanSocietyofAnesthesiology，ASA）IⅢ级，年龄2971岁，随机分为两组（n=40）：Dex组（D组）及安慰剂组（P组）。诱导前两组患者分别以Dex（1μg·kg^-1，4μg·mL^-1）和等量生理盐水泵入15min，随后常规麻醉诱导，以FOB行经口气管插管，记录入室后5min（基础值）、麻醉诱导前、气管插管前、气管插管即刻及气管插管后1，2，3，5，10min的血压、心率和脑电双频指数（bispectralidex，BIS）。观察患者气管插管的血流动力学变化及相关并发症。结果：与P组患者相比，麻醉诱导和气管插管期间，D组患者血流动力学平稳（P〈0．05），并发症发生率低（但P〉0．05）。结论：麻醉诱导前输注Dex，可以减轻FOB引导气管插管血液动力学反应并减少其相关并发症。Objective ： To investigate the use of dexmedetomidine （Dex） in intratracheal intubation with fi-beroptic bronchoscope （FOB） in thyroid surgeries under general anesthesia. （20 male, 60 female） aged 29 - 71 years weighing 45 - 80 kg scheduled for sia with tracheal intubation were randomly divided into Dex group（ group D） each）. Before induction, patients of the two groups received Dex （group D, Methods： Eighty ASA IⅢ patients thyroid surgery under general anesthe- and placebo group （ group P） （ n = 40 μg·kg^-1 - 1,4 μg·kg^-1） or same volumeof normal saline （group P） infusion for 15 min, respectively. After induction of anesthesia, orotracheal intubation was performed with FOB. BP, HR, and BIS were recorded noninvasively at 5 min after entrance to the operation room, the time before induction,the time before and just the time of tracheal intubation and at 1,2,3,5,10 min after tracheal intubafion. Hemodynamic response and complications of intratracheal intubation were observed. Resuits： The hemodynamic responses to intubation were significantly different between group P and group D （P 〈 0.05 ）. Less complications of intubation were observed in group D compared with group P（ but P 〉 0.05 ）. Conclusion ： Infusion of Dex before induction can prevent the hemodynamic responses to intubation with FOB ,thus reducerelevant complications.

关 键 词：右旋美托咪定 光导纤维支气管镜 气管插管 血流动力学反应 并发症 

分 类 号：R971.21[医药卫生—药品]