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作 者:陈宗[1,2] 温有峰[1] 马传根[2] 张义轩[2]
机构地区:[1]辽宁医学院研究生学院,辽宁锦州121001 [2]河南大学淮河医院麻醉科,河南开封475000
出 处:《中国药房》2016年第11期1539-1541,共3页China Pharmacy
摘 要:目的:观察右美托咪定对老年心房颤动患者麻醉诱导期血流动力学及心血管事件的影响。方法:58例老年心房颤动患者按随机数字表法分为对照组(28例)与观察组(30例)。对照组患者给予常规麻醉;观察组患者在对照组基础上于麻醉诱导前给予右美托咪定0.6μg/kg,ivgtt,15 min内完成。比较两组患者麻醉诱导期入室后(T0)、右美托咪定输注停止后即刻(T1)、气管插管前即刻(T2)及气管插管后1 min(T3)、3 min(T4)、5 min(T5)的脑电双频谱指数(BIS)和血流动力学变化情况、麻醉复苏时间及心血管事件发生率。结果:观察组患者T1-T4时段的BIS、心率(HR)水平显著低于T0时,收缩压(SBP)、舒张压(DBP)显著高于T0时,差异有统计学意义(P〈0.05)。观察组患者T1-T4时段的SBP、DBP水平显著低于对照组,BIS、HR水平显著高于对照组,差异有统计学意义(P〈0.05);两组患者T5时上述指标比较,差异均无统计学意义(P〉0.05)。观察组患者呼吸恢复时间、呼唤睁眼时间及定向力恢复时间均显著短于对照组,差异有统计学意义(P〈0.05)。观察组患者低血压及心动过速心血管事件发生率显著低于对照组,差异有统计学意义(P〈0.05);两组患者心动过缓及高血压心血管事件发生率比较,差异无统计学意义(P〉0.05)。结论:右美托咪定能有效稳定老年心房颤动患者麻醉诱导期血流动力学指标,促进患者麻醉恢复,降低部分心血管事件发生率。OBJECTIVE:To observe the effects of dexmedetomidine on hemodynamics during anesthesia induction and cardiovascular events of elderly patients with atrial fibrillation. METHODS:58 patients with atrial fibrillation were randomly divided into control group(28 cases)and observation group(30 cases). Control group was given regular anesthesia;observation group was additionally given dexmedetomidine 0.6 μg/kg,ivgtt,within 15 min before anesthesia induction on the basis of control group. The hemodynamics,anesthesia recovery time and the incidence of cardiovascular events were compared between 2 groups after entering the operation room(T0),immediately after stopping intravenous infusion of dexmedetomidine(T1),immediately before intubation(T2),1,3 and 5 min after intubation(T3,T4 and T5). RESULTS:BIS and HR of observation group at T1-T4 were significantly lower than at T0,while SBP and DBP at T1-T4 were significantly higher than T0,with statistical significance(P〈0.05). SBP and DBP of observation group at T1-T4 were significantly lower than those of control group,and BIS and HR at T1-T4 were significantly higher than control group,with statistical significance(P〈0.05). The breathing recovery time,eye opening time and orientation recovery time of observation group were all significantly shorter than those of control group,with statistical significance(P〈0.05).The incidence of cardiovascular events as hypotension and tachycardia in observation group was significantly lower than that in control group,with statistical significance(P〈0.05);the difference was not statistically significant between 2 groups of patients and hypertension(P〉0.05). CONCLUSIONS:Dexmedetomidine can effectively stabilize hemodynamic index in elderly patients with atrial fibrillation during anesthesia induction period,promote recovery from anesthesia and reduce the incidence of cardiovascular and cerebrovascular events.
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