右美托咪定对腹腔镜子宫切除术患者靶控输注维库溴铵的肌松效应和需求量的影响  

Effect of Dexmedetomidine on muscle relaxant and demand of target controlled infusion of Vecuronium in patients with laparoscopic hysterectomy

作　　者：杨庆耿 刘煌 孙岸灵[2] 郭文斌 纪浩聪[3] 

机构地区：[1]广东省惠州市第一妇幼保健院麻醉科,广东惠州516001 [2]广东省惠州市中心人民医院麻醉科,广东惠州516001 [3]广东省惠州市第一人民医院麻醉科,广东惠州516001

出　　处：《中国医药导报》2016年第16期58-61,共4页China Medical Herald

基　　金：广东省医学科学技术研究基金(B409)

摘　　要：目的 研究右美托咪定对腹腔镜子宫切除术患者靶控输注维库溴铵的肌松效应和需求量的影响。方法 选取2015年3月～2016年2月于惠州市第一妇幼保健院行腹腔镜子宫切除术通过气管插管全麻的患者50例,采用随机数字表法,将其分为两组,每组各25例。对照组给予靶控输注维库溴铵,观察组则在靶控输注维库溴铵之前预注右美托咪定。观察两组患者输注前即刻（T1）、插管后5 min（T2）、插管后15 min（T3）的血压和心率（HR）情况,比较两组肌松情况以及术中维库溴铵需求量。结果 T1时刻观察组患者的收缩压（SBP）、舒张压（DBP）和HR均明显低于对照组,差异有统计学意义（P〈0.05）,而在T2和T3时刻,两组患者的SBP、DBP和HR差异无统计学意义（P〉0.05）。观察组维库溴铵的起效时间明显短于对照组,25%、50%、75%和90%恢复时间均明显长于对照组,差异均有统计学意义（均P〈0.05）。观察组维库溴铵需求量明显低于对照组,差异有统计学意义（P〈0.05）。结论 右美托咪定能够缩短腹腔镜子宫切除术患者靶控输注维库溴铵的起效时间,延长其作用时间,降低术中维库溴铵的需求量。Objective To explore the effect of Dexmedetomidine on muscle relaxant and demand of target controlled infusion of Vecuronium in patients with laparoscopic hysterectomy. Methods 50 cases of patients underwent laparoscopic hysterectomy by general anesthesia in the First Maternal and Child Health Care of Huizhou City from March 2015 to February 2016 were selected. According to the random number table, they were randomly divided into two groups, each group had 25 cases. The control group received target controlled infusion of Vecuronium, the observation group was pre-injected Dexmedetomidine before target-controlled infusion of Vecuronium. The blood pressure and heart rate （HR） at the time before the infusion （T1）, 5 min after intubation （T2）, 15 min after intubation （T3） of the two groups were observed; and the muscle relaxant, Vecuronium demand were compared between the two gorups. Results At Tl time, the SBP, DBP and HR of the observation group were significantly lower than those of the control group, the differences were statistically significant （P 〈 0.05） , but at T2 time and T3 time, the SBP, DBP and HR of the two groups had no significant differences （P 〉 0.05）. The Vecuronium onset time of the observation group was significantly shorter than that of the control group, 25%, 50%, 75% and 90% recovery time were significantly longer than those of the control group, the differences were statistically significant （P 〈 0.05）. The Vecuronium demand of the observation group was significantly lower than that of the control group, the difference was statistically significant （P 〈 0.05）. Conclusion Dexmedetomidine can shorten the onset time of laparoscopie hysterectomy patients with target controlled infusion of Vecuronium, extend the duration of Vecuronium action, reduce the demand of Vecuronium in surgery.

关 键 词：右美托咪定 维库溴铵 维持时间 影响 

分 类 号：R614.2[医药卫生—麻醉学]