右美托咪定用于普外科全麻手术中对非去极化肌松药罗库溴铵作用的影响  

Effects of dexmedetomidine on the non depolarizing muscle relaxant rocuronium under general anesthesia operation in general surgery

作　　者：薛国剑[1] 郝建华[1] 李平[1] 赵京禹[1] 张锦荣[1] 李萌萌[1] 

机构地区：[1]中国人民解放军总医院第一附属医院麻醉科,北京100048

出　　处：《实用药物与临床》2015年第3期277-280,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨右美托咪定在改善普外科全麻手术患者血流动力学中的作用,并研究其对非去极化肌松药罗库溴铵起效及维持时间的影响。方法收集我院在全身麻醉下行普外科手术的患者226例,按照随机数字表法分为对照组和观察组,每组113例,两组患者均应用尺神经刺激器对肌松情况进行监测,并在患者进入手术室后定标。在麻醉诱导前,观察组予以1.0μg/kg右美托咪定静脉泵注15 min,对照组予以等量的生理盐水。记录两组患者右美托咪定用药前（T1）、用药后（T2）、气管插管前（T3）、气管插管时（T4）、气管插管后10min（T5）、气管插管后30 min（T6）的心率（HR）、收缩压（SBP）及舒张压（DBP）的监测结果,及两组患者罗库溴铵的起效和维持时间。结果在T2时间点上,观察组HR显著低于对照组（P〈0.01）。T3时间点上,观察组HR显著低于对照组（P〈0.05）,而DBP及SBP显著高于对照组（P〈0.05）。T4～T6时间点上,观察组HR、DBP及SBP均显著低于对照组,差异有统计学意义（P〈0.05）。同时,观察组罗库溴铵的起效时间显著短于对照组（P〈0.01）,且无反应时间显著长于对照组（P〈0.05）。结论右美托咪定应用于普外科全麻手术中能够有效降低患者的应激反应,改善患者血流动力学状况,并能迅速缩短非去极化肌松药罗库溴铵的起效时间和延长维持时间,从而增强了罗库溴铵的肌松作用。Objective To explore the hemodynamics effects of dexmedetomidine on the non depolarizing muscle relaxant rocuronium under general anesthesia operation in general surgery. Methods Two hundred and twenty-six patients who were under general anesthesia operation in general surgery of our hospital were randomly divided into observation group and control group,with 113 patients in each group. Muscle relaxation of the two groups were monitored by ulnar nerve stimulator,the calibration were confirmed when patients were wheeled into the operating room. Before induction of anesthesia,patients in observation group were given intravenous infusion of 1. 0 μg / kg dexmedetomidine for 15 min,patients in control group were given the same dose of normal saline. HR,SBP and DBP of the two groups before treatment（ T1）,after treatment（ T2）,before tracheal intubation（ T3）,at the time of tracheal intubation（ T4）,after tracheal intubation（ T5）,at 30 min after tracheal intubation（ T6）,and the onset and duration time of rocuronium of the two groups were recorded and compared. Results HR of observation group was significantly lower than that of control group at T2（P〈0. 01）. HR of observation group was lower,and DBP and SBP of observation group were higher than those of control group at T3（P〈0. 05）. The onset time of rocuronium in observation group was shorter than that of control group（P〈0. 01）,the duration time of rocuronium in observation group was shorter than that of control group（P〈0. 05）. Conclusion Dexmedetomidine can reduce the stress response,improve the hemodynamic status effectively,accelerate the onset and duration time,improve the effect of rocuronium in patients under general anesthesia operation in general surgery

关 键 词：右美托咪定 罗库溴铵 血流动力学 起效时间 维持时间 

分 类 号：R614[医药卫生—麻醉学]