右美托咪定对老年胸科患者拔管期血流动力学的影响  

Effects of dexmedetomidine on hemodynamics during endotracheal extubation period in aged patients

作　　者：叶伟光[1] 王天龙[1] 

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053

出　　处：《北京医学》2015年第8期739-741,共3页Beijing Medical Journal

摘　　要：目的 观察右美托咪定对行肺癌根治术老年患者拔管期间血流动力学的影响。方法 选择50例拟在全身麻醉下行择期肺癌根治术的患者,年龄65～75岁,ASAⅡ～Ⅲ级,随机分为右美托咪定组（观察组）和生理盐水组（对照组）,每组25例。两组分别在手术关胸前15 min经静脉微量泵持续输注右美托咪定0.5μg/kg和等容量生理盐水,输注时间为15 min。于给药前（T0）,给药后5、10、15 min（T1-3）,拔管前1 min（T4）,拔管即刻（T5）,拔管后3、5、10 min（T6-8）记录两组患者的平均动脉压（MAP）、心率（HR）、心指数（CI）,并记录两组患者苏醒时间、拔管时间和Ramsay评分。结果 观察组T2、T3的MAP、HR、CI较T0均显著下降（P〈0.05）;观察组T5、T6、T7的MAP、HR、CI均明显低于对照组（P〈0.05）,但与T4比较差异无统计学意义（P〉0.05）;两组患者的苏醒时间、拔管时间和Ramsay评分比较差异均无统计学意义（P〉0.05）。结论 静脉输注右美托咪定可显著减轻老年患者双腔管拔管时的心血管反应,维持血流动力学的稳定,且对麻醉苏醒没有明显影响。Objective To investigate the effects of dexmedetomidine on hemodynamics during endotracheal extubation period in patients with pulmomonary carcinoma undergoing lung resection.Methods Fifty ASAⅡ or Ⅲ patients,aged 65～75 yrs,scheduled for lung resection surgery,were randomly assigned to two groups（n=25 each）：the dexmedetomidine group（group D） and the saline control group（group C）.Fifteen minutes before sternal closure,dexmedetomidine0.5 μg/kg and saline were infused over 15 minutes respectively.MAP、HR and CI were recorded before drug infusion（T0）,at 5、10、15 min after infusion（T1-3）,before extubation（T4）,immediately after extubation（T5）,at 3、5、10 min after extubation（T6- 8）.The recovery time、extubation time and Ramsay score during extubation were recorded.Results Compared with T0,MAP、HR、CI were significantly decreased at T2 and T3in group D（P 〈0.05）.MAP、HR、CI in group D were significantly lower at T5-7compared with group C（P 〈0.05）.There were no significant differences in recovery time、extubation time and Ramsay conscious-sedation score between the two groups（P 〉0.05）.Conclusion Dexmedetomidine can effectively reduce cardiovascular responses to tracheal extubation in aged patients and have hemodynamic-stabilizing effects while not prolonging the recovery time from anesthesia.

关 键 词：老年 右美托咪定 拔管 血流动力学 

分 类 号：R614[医药卫生—麻醉学]