右美托咪定用于七氟醚诱导气管插管时血流动力学及BIS的变化  

Effect of Dexmedetomidine on the Hemodynamic and BIS during Anesthetic Induction with Sevoflurane and Tracheal Intubation

作　　者：咸淑悦 周妙苗[1] 马敏[1] 王成夭[1] 

机构地区：[1]武汉大学中南医院麻醉科,湖北武汉430071

出　　处：《贵阳医学院学报》2015年第3期294-296,共3页Journal of Guiyang Medical College

基　　金：武汉大学自主科研青年教师项目(No:2042014kf0188)

摘　　要：目的：观察右美托咪定对七氟醚诱导气管插管时血流动力学及镇静深度的影响。方法：择期全麻下行耳鼻喉手术患者36例,ASA分级Ⅰ~Ⅱ级,随机均分为对照组（A组）、高剂量芬太尼组（B组）、右美托咪定组（C组）,A、B组诱导时分别给予芬太尼2μg/kg和4μg/kg,C组麻醉诱导前15 min内静脉泵注右美托咪定1.0μg/kg,诱导时给予芬太尼2μg/kg;3组均给予七氟醚＂潮气量法＂诱导,记录3组患者给药前（T0）、开始吸入七氟醚即刻（T1）、气管插管前即刻（T2）、气管插管后即刻（T3）的收缩压（SBP）、舒张压（DBP）、心率（HR）、脑电双频指数（BIS）并分析。结果：3组患者T0时点基础BIS、SBP、DBP及HR比较;差异无统计学意义（P〉0.05）;T1与T0时点比较,C组SBP、HR及BIS值显著低于A、B两组,T2时点C组患者的SBP显著高于A、B两组,差异有统计学意义（P〈0.05）;T3时点C组患者的SBP、DBP及HR显著低于A组,BIS低于A、B两组,差异有统计学意义（P〈0.05）。结论：七氟醚诱导插管时右美托咪定在降低BIS的同时可维持稳定的血流动力学。Objective： To observe the effect of dexmedetomidine on the hemodynamic and BIS during anesthetic induction with sevoflurane and tracheal intubation. Methods： Thirty-six American Society of Anesthesiology（ ASA） physical status I and II patients,undergoing selective otorhinolaryngologic operation under general anesthesia were randomly divided into three groups. Group A received saline solution 15 minutes before anesthetic induction and fentanyl 2 μg/kg during induction; Group B received saline solution 15 minutes before anesthetic induction and fentanyl 4 μg/kg during induction; Group C received dexmedetomidine at an initial dose of 1. 0 μg/kg 15 minutes before anesthetic induction and fentanyl 2 μg/kg during induction. Patients of the three groups all received tidal breathing induction with sevoflurane. The hemodynamic parameters： systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,heart rate（ HR） and BIS were recorded at four time points： the moment before the use of saline solution or dexmedetomidine（ T0）,the moment before sevoflurane induction（ T1）,the moment before intubation（ T2） and the moment after intubation（ T3）. Results： Compared with T0,SBP and HR of Group C at T1 were significantly lower than those of Group A and Group B（ P〈0. 05）; SBP of Group C was siginificantly higher than that of Group A and Group B at T2（ P〈0. 05）; At T3,SBP,DBP and HR of Group C were significantly lower than those of Group A（ P〈0. 05） while BIS of Group C was lower than that of Group A and Group B（ P〈0. 05）. Conclusion： Dexmedetomidine can reduce BIS value and make the hemodynamic stable during the induction with sevoflurane and tracheal intubation.

关 键 词：右美托咪定 七氟醚 脑电双频指数 血流动力学 插管法 气管内 

分 类 号：R614.24[医药卫生—麻醉学]