右美托咪定预先给药对双腔气管导管插管的血流动力学影响  

Effects of dexmedetomidine pretreatment on hemodynamics of double lumen endotracheal tube intubation

作　　者：余世荣[1] 周本宏[2] 刘芳[1] 

机构地区：[1]湖北医药学院附属人民医院药学部,湖北十堰442000 [2]武汉大学人民医院,湖北武汉430060

出　　处：《中国医院药学杂志》2015年第14期1317-1320,共4页Chinese Journal of Hospital Pharmacy

基　　金：2012年十堰市科学技术研究与开发项目计划(编号:078S)

摘　　要：目的：观察右美托咪定预先给药对双腔气管导管插管的血流动力学影响。方法：选择择期双腔气管导管插管全麻开胸手术患者60例,ASAⅠ～Ⅱ级,随机分为2组：右美托咪定组（dexmedetomidine,D组）和对照组（control,C组）,每组30例。D组于麻醉诱导前10 min,用微量泵静脉给予Dex负荷量1.0μg·kg^-1,静脉泵入10 min后开始麻醉诱导。之后输注速度设定为0.4～0.6μg·kg^-1·h^-1直至手术结束。C组用等量生理盐水代替右美托咪定静脉泵入。记录患者入室时的基础值（T0）、静脉泵注用药后5 min（T1）、麻醉诱导后气管插管前（T2）、气管插管后1 min（T3）、气管插管后3 min（T4）及气管插管后10 min（T5）平均动脉压（MAP）、心率（HR）、血氧饱和度（SPO2）及呼气末二氧化碳分压（PetCO2）;记录两组患者高血流动力学的发生率及所用血管活性药物的量。结果：2组患者HR和MAP在麻醉诱导后气管插管前均下降。C组患者HR和MAP,在气管插管后1 min（T3）、气管插管后3 min（T4）明显升高（P〈0.01）;而D组患者变化不明显（P〉0.05）。C组患者高血流动力学反应的发生率（T3和T4）明显高于D组（P〈0.01）。结论：右美托咪定预先给药能有效抑制双腔气管导管插管的应激反应并维持血流动力学的稳定。OBJECTIVE To observe effects of dexmedetomidine pretreatment on hemodynamics of double lumen endotracheal tube intubation.METHODS A total of 60 cases of double lumen endotracheal intubation anesthesia at ASA Ⅰ-Ⅱ were selected in patients undergoing thoracic operation,which were randomly divided into two groups,including Dex group（Group D）and control group（Group C）.Each group included 30 cases.All patients in group D were pumped 1.0μg·kg^-1 Dex intravenously10 minutes before anesthesia induction followed by continuous infusion of dexmedetomidine 0.4-0.6μg·kg^-1·h^-1 until operation was completed.Patients in group C received the same amount of normal saline.MAP and HR and adverse reactions were observed before drug administration（T0）,5 minutes after drug administration（T1）,after induction of anesthesia（T2）,immediately after intubation（T3）and 3 and 10 minutes after intubation（T4and T5,respectively）.I Incidence of hyperdynamic response and total doses of nicardipine,esmol and atropine in these two group were recorded.RESULTS Both HR and MAP of two groups decreased at T2.MAP and HR of group C increased significantly at T3 and T4（P〈0.01）.Compared to baseline values,MAP and HR of group D decreased slightly after induction（P〉0.05）.Incidence of high hemodynamic responses in group C was significantly higher than that of group D at T3 and T4（P〈0.01）.CONCLUSION Dexmedetomidine pretreatment can efficiently inhibit stress response of double lumen endotracheal intubation and maintain hemodynamic stability.

关 键 词：右美托咪定 开胸手术 双腔气管插管 血流动力学反应 

分 类 号：R969[医药卫生—药理学]