右美托咪定用于腹腔镜减肥手术麻醉的临床观察  

Clinical observation of dexmedetomidine given anesthesia for laparoscopic bariatric surgery

作　　者：汪润[1] 刘鹏飞[1] 关雷[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院麻醉科,北京100038

出　　处：《中国实验诊断学》2016年第4期634-637,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的观察右美托咪定用于腹腔镜减肥手术(胃肠旁路术)麻醉的麻醉效果和对血流动力学的影响。方法选择ASAⅠ或Ⅱ级择期行腹腔镜减肥手术的患者80例,分为右美托咪定复合丙泊酚组(D+P组)和丙泊酚组(P组)。D+P组患者给予0.5μg/kg右美托咪定泵注10min,常规麻醉诱导,术中以右美托咪定0.3μg/kg/h和丙泊酚,瑞芬太尼维持输注。P组患者直接麻醉诱导后行气管插管,术中以丙泊酚和瑞芬太尼维持输注。两组均于手术结束前30min逐步停用药物。观察两组患者各时间点的血压,心率,BIS,丙泊酚用量,苏醒时间,拔管时间,术后躁动和恶心呕吐情况。结果两组术中血流动力学均相对稳定,D+P组在插管时和拔管时血压和心率明显低于P组,有统计学意义(P<0.05)。D+P组丙泊酚术中使用量明显少于P组(P<0.05)。D+P组苏醒时间略长于P组,但无统计学意义(P>0.05),术后躁动,恶心呕吐显著低于P组(P<0.05)。结论右美托咪定复合丙泊酚麻醉用于肥胖患者实施腹腔镜减肥手术可以维持术中血流动力学的稳定,苏醒质量更好,不良事件发生率更低。Objective Observation dexmedetomidine set for laparoscopic bariatric surgery（gastrointestinal bypass surgery）anesthesia anesthetic effect and impact on hemodynamics.Methods Select ASAⅠ orⅡ patients undergoing elective laparoscopic bariatric surgery 80 patients,divided into dexmedetomidine given propofol group（D＋P group）and propofol group（P group）.D＋P group were treated with 0.5μg/kg given dexmedetomidine infusion 10 min,conventional induction of anesthesia,surgery to dexmedetomidine given 0.3μg/kg/h and propofol,remifentanil maintenance infusion.P group induction of anesthesia patients underwent intubation,surgery to maintain the infusion of propofol and remifentanil.Both groups surgery 30 min before the end of the phasing out of drugs.Blood pressure were observed at each time point,the heart rate,BIS,propofol dosage,awakening time,extubation time,postoperative nausea and vomiting and restlessness.Results Both groups were relatively stable hemodynamics,D＋P group intubation and extubation blood pressure and heart rate was significantly lower than P group was statistically significant（P0.05）.D＋P group the amount of propofol intraoperative use of significantly less than the P group（P0.05）.D＋P group recovery time slightly longer than the P group,but not statistically significant（P0.05）,postoperative restlessness,nausea and vomiting was significantly lower than P group（P0.05）.Conclusion Dexmedetomidine given propofol anesthesia for laparoscopic bariatric surgery in obese patients can maintain a stable intraoperative hemodynamics,recovery and better quality,lower incidence of adverse events.

关 键 词：右美托咪定 丙泊酚 腹腔镜减肥手术 全身麻醉 血流动力学 

分 类 号：R614[医药卫生—麻醉学]