不同剂量的右美托咪啶在老年颌面外科麻醉气管插管时对心血管反应的疗效比较  

Therapeutic effect comparison of different doses of dexmedetomidine on the cardiovascular reactions during tracheal intubation with surgical anesthesia at maxillofacial region in senile patients

作　　者：梁晓君[1] 张洪杰[1] 

机构地区：[1]天津市口腔医院麻醉科,300041

出　　处：《现代口腔医学杂志》2016年第3期160-162,共3页Journal of Modern Stomatology

摘　　要：目的研究不同剂量的右美托咪啶（DEX）在老年颌面外科麻醉气管插管时对心血管反应的影响,并对其镇静效果作一评估。方法选择腮腺肿物、下颌下腺肿物等择期手术患者80例（ASAⅠ-Ⅲ级,年龄60-75岁）采用随机数字表法分为四组（n=20）：A组（生理盐水对照组）,B组（0.25μg/kg DEX组）,C组（0.5μg/kg DEX组）和D组（1μg/kg DEX组）。用生理盐水将不同剂量右美托咪啶稀释至50ml分别在麻醉诱导前10min内恒速输注完闭,而后开始麻醉诱导并行气管插管,记录入室后（T0）在注入右美托咪啶结束时（T1）,气管插管前（T2）,在气管插管时（T3）和气管插管后5min（T4）的血管收缩压（SBP）,舒张压（DBP）,心率（HR）、血氧饱和度（SpO2）等数值。观察不同剂量的右美托咪啶对血流动力学的影响,评估其镇静作用。结果与A组比较,C组T3时SBP和DBP值HR值有显著性差异（P〈0.05）,D组的SBP和DBP值HR值在T1,T3和T4均有有显著性差异（P〈0.05）,C组D组警觉/镇静（OAA/S）评分在T1与A组比较有显著差异（P〈0.05）;尤其D组更为明显。结论 0.5μg/kg右美托咪啶可有效的抑制气管插管时患者的心血管反应,无呼吸抑制作用,很适合老年颌面外科患者的麻醉。Objective To investigate the influences of different doses of dexmedetomidine（DEX） on the cardiovascular reactions during tracheal intubation with surgical anesthesia at the maxillofacial region in senile patients and assess their sedation effects. Methods Altogether 80 cases of patients planed for operation for parotid gland masses and salivary gland masses（ASA grades Ⅰ to Ⅲ, aged 60 to 75）are selected and divided into four groups（n=20）by the random number table method： Group A（normal saline control group）, Group B（0.25μg/kg DEX group）, Group C（0.5μg/kg DEX group）, and Group D（1μg/kg DEX group）. Dilute the different doses of DEX with normal saline to 50 ml, and complete infusing them at a constant speed within 10 minutes before anesthesia induction. Then start anesthesia induction and perform tracheal intubation at the same time. And record the such values as the systolic blood pressure（SBP）, the diastolic blood pressure（DBP）, the heart rate（HR）, and the saturation of blood oxygen（SpO2）when the trachea is introduced into the ventricle（T0）, when the injection of DEX is completed（T1）, before tracheal intubation（T2）, during tracheal intubation（T3）, and 5 minutes after tracheal intubation（T4）. Investigate the influences of different doses of DEX on the haemodynamics and assess their sedation effects. Results Compared with Group A, the SBP, DBP and HR values at T3 of Group C are significantly different（P〈0.05）, the SBP, DBP and HR values at T1, T3 and T4 of Group D are all significantly different（P〈0.05）, and the alert/sedation（OAA/S）scores at T1 of Group C and Group D are significantly different（P〈0.05）from those of Group A, and those of Group D are more significantly different. Conclusion DEX at a dose of 0.5μg/kg can effectively inhibit the cardiovascular reactions of the patients during tracheal intubation without a respiration inhibition effect. It is very suitable for the anesthesia in senile patients undergoing surg

关 键 词：老年人 颌面外科 右美托咪啶 镇静 

分 类 号：R614[医药卫生—麻醉学]