右美托咪定在老年高血压患者气管插管全身麻醉中的应用效果观察  

Application Effect of Dexmedetomidine in the Endotracheal Intubation General Anesthesia of Elderly Patients With Hypertension

作　　者：马燕[1] 何锡强[1] 王庚[1] 

机构地区：[1]北京积水潭医院麻醉科,北京市100035

出　　处：《实用心脑肺血管病杂志》2016年第1期73-76,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的观察右美托咪定在老年高血压患者气管插管全身麻醉中的应用效果。方法选取2012年1月—2015年1月在北京积水潭医院行气管插管全身麻醉的老年高血压患者96例,采用随机数字表法分为观察组和对照组,各48例。观察组患者自麻醉诱导前10 min开始持续静脉泵入右美托咪定至手术完成前30 min,对照组患者自麻醉诱导前10 min开始持续静脉泵入0.9%氯化钠溶液至手术完成前30 min。比较两组患者手术时间、麻醉时间、拔管时间和苏醒时间;比较两组患者入室前、插管前1 min、插管即刻、插管后2 min、拔管前1 min和拔管后2 min血压、心率;比较两组患者插管前1 min、插管即刻、插管后2 min、拔管前1 min和拔管后2 min Ramsay镇静评分;比较两组患者不良反应发生情况。结果两组患者手术时间、麻醉时间、拔管时间和苏醒时间比较,差异无统计学意义(P>0.05)。两组患者入室前和插管前1 min收缩压、舒张压、心率比较,差异无统计学意义(P>0.05);观察组患者插管即刻、插管后2 min、拔管前1 min和拔管后2 min收缩压、舒张压、心率低于对照组(P<0.05);观察组患者插管前1 min、插管即刻、插管后2 min、拔管前1 min和拔管后2 min Ramsay镇静评分均高于对照组(P<0.05);两组患者寒战、苏醒延迟、口干、心动过缓及低血压发生率比较,差异无统计学意义(P>0.05)。结论右美托咪定可减少老年高血压患者气管插管全身麻醉过程中血压、心率波动,有利于保持血流动力学稳定,镇静效果良好,且麻醉安全性较高。Objective To observe the application effect of dexmedetomidine in the endotracheal intubation general anesthesia of elderly patients with hypertension. Methods A total of 96 elderly patients with hypertension undergoing endotracheal intubation general anesthesia were selected in Jishuitan Hospital of Beijing from January 2012 to January 2015,and they were divided into control group and observation group according to random number table, each of 48 cases. Patients of observation group received continous intravenous pumping of dexmedetomidine 10 minutes before anesthesia induction until 30 minutes before the completion of surgery,while patients of control group received continous intravenous pumping of 0. 9% sodium chloride injection. Duration of surgery,duration of anesthesia,extubation time and awakening time were compared between the two groups; blood pressure and heart rate before entering into operating room, 1 minute before endotracheal intubation,immediately after endotracheal intubation,2 minutes after endotracheal intubation,1 minute before extubation and 2 minutes after extubation were compared between the two groups; Ramsay score 1 minute before endotracheal intubation,immediately after endotracheal intubation,2 minutes after endotracheal intubation,1 minute before extubation and 2 minutes after extubation was compared between the two groups, respectively; and incidence of adverse reactions was observed. Results No statistically significant differences of duration of surgery,duration of anesthesia,extubation time or awakening time was found between the two groups（ P〉0. 05）. No statistically significant differences of SBP, SDP or heart rate was found between the two groups before entering into operating room or 1 minute before endotracheal intubation（ P〉0. 05）; SBP, SDP and heart rate of observation group were statistically significantly lower than those of control group immediately after endotracheal intubation,2minutes after endotracheal intubation,1 minute before extubation and 2 minutes af

关 键 词：高血压 老年人 右美托咪定 气管插管 麻醉 全身 

分 类 号：R544.1[医药卫生—心血管疾病]