右美托咪啶对高血压患者全麻拔管期血浆儿茶酚胺的影响  

Effect of Dexmedetomidine on plasma catecholamines of patients with hypertension in extubating period of general anesthesia

作　　者：杨柳[1] 江伟[1] 税春玲[1] 杨建平[1] 

机构地区：[1]重庆医科大学附属永川医院麻醉科,重庆402160

出　　处：《中国医药导报》2016年第1期79-82,共4页China Medical Herald

基　　金：重庆市永川区科委科研项目(YCSTC;2012BE5014)

摘　　要：目的观察右美托咪啶对高血压患者全麻拔管期血浆儿茶酚胺浓度的影响,为右美托咪啶在高血压患者中的合理应用提供依据。方法选择2013年5月-2015年7月重庆医科大学附属永川医院收治的原发性高血压病患者30例为研究对象,所有患者均择期行腹腔镜胆囊切除术,将其随机分为A组（0.5μg/kg右美托咪啶剂量组）、B组（0.3μg/kg右美托咪啶剂量组）和C组（生理盐水对照组）,每组各10例。常规麻醉诱导与维持,手术结束切口缝合完毕前15 min,各组泵注相应剂量的右美托咪啶或同体积生理盐水,泵注10 min。测定各组患者用药前（T0）、用药结束后5 min（T1）、拔管后5 min（T2）血浆儿茶酚胺浓度。结果组内比较：T1与T0比较,A组血浆肾上腺素、去甲肾上腺素浓度明显降低（P〈0.05）;在T2时点,A组血浆去甲肾上腺素浓度及B、C两组的血浆去甲肾上腺素、肾上腺素浓度明显高于T1时点（P〈0.05）。组间比较：T0时点三组患者血浆肾上腺素、去甲肾上腺素浓度比较,差异无统计学意义（P〉0.05）;在T1、T2时点,A组血浆肾上腺素、去甲肾上腺素浓度明显低于C组（P〈0.05）,B组与C组差异无统计学意义（P〉0.05）;T1时点A组血浆去甲肾上腺素浓度明显低于B组（P〈0.05）;T2时点A组血浆肾上腺素、去甲肾上腺素浓度明显低于B组（P〈0.05）。结论右美托咪啶可明显抑制高血压患者全麻拔管期应激引起的血浆儿茶胺浓度升高,且以0.5μg/kg剂量为宜。Objective To investigate the effect of Dexmedetomindine on plasma catecholamine concentrations of patients with hypertension in extubating period of general anesthesia,and provide a basis for reasonable application of Dexmedetomidine in patients with hypertension.Methods From May 2013 to July 2015,30 patients with essential hypertension undergoing elective laparoscopic cholecystectomy in Affiliated Yongchuan Hospital of Chongqing Medical University were selected as study objects,and they were randomly divided into three groups,group A（0.5 μg/kg Dexmedetomidine group）,group B（0.3 μg/kg Dexmedetomidine group）,and group C（saline group）,10 cases in each group.15 minutes before the end of operation,patients were given Dexmedetomidine or the same volume of physiological saline infusion,for 10 minutes.Plasma catecholamine concentration was determined at T0（before treatment）,T1（5 min after treatment）,T2（5 min after extubation）.Results Comparison within groups,concentrations of plasma epinephrine and norepinephrine at T1 in group A were significantly lower than that at T0（P〈0.05）;concentrations of plasma norepinephrine at T2 in three groups were significantly higher than that at T1（P〈0.05）;concentrations of plasma epinephrine at T2 in group B and group C were significantly higher than that at T1（P〈0.05）.Comparison among groups,at T0,there was no significant difference in plasma catecholamine concentrations among the three groups（P〈0.05）;at T1 and T2,the concentrations of plasma epinephrine and norepinephrine in the group A were significantly lower than those in the group C（P〈0.05）,and there was no significant difference between the group C and B（P〈0.05）;at T1,plasma norepinephrine concentration in group A was significantly lower than that in the group B（P〈0.05）;concentrations of plasma epinephrine and norepinephrine at T2 of group A were significantly lower than those in group B（P〈0.05）.Conclusion Dexmedetomidine can inhibit plasma catecholamine con

关 键 词：右美托咪啶 血浆儿茶酚胺 全麻拔管期 高血压 

分 类 号：R614.1[医药卫生—麻醉学]