快速序贯诱导前预注右美托咪定对插管条件及血流动力学的影响  

Effects of priming dexmedetomidine before rapid-sequence induction on intubation conditions and hemodynamics

作　　者：朱兆平[1] 郭艾芳 ZHU Zhaoping;GUO Ai fang(Department of Anesthesiology,Tai＇an First People＇s Hospital,Tai＇an,Shandong 271000,China)

机构地区：[1]山东省泰安市第一人民医院麻醉科,271000

出　　处：《检验医学与临床》2018年第12期1780-1782,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨快速序贯诱导(RSI)前预注右美托咪定对插管条件及血流动力学的影响。方法选择2016年7月至2017年6月在该院妇科行气管插管全身麻醉手术的96例患者作为研究对象,按照随机数字表法分为对照组(48例)和观察组(48例)。对照组患者给予泵注10mL 0.9%氯化钠注射液,观察组患者给予RSI前泵注0.6μg/kg的右美托咪定注射液,两组患者均给予相同的麻醉操作和药物。比较两组患者诱导前后心率(HR)、平均动脉压(MAP)、血流速度、颅内动脉平均流速和搏动指数、血氧分压(PaO_2)和二氧化碳分压(PaCO2)及并发症。结果观察组患者HR和MAP低于对照组,差异均有统计学意义(P<0.05)。观察组患者血流速度、颅内动脉平均流速和搏动指数低于对照组,差异均有统计学意义(P<0.05)。观察组患者PaO_2和PaCO_2低于对照组,差异均有统计学意义(P<0.05)。观察组患者并发症发生率为16.67%(8/48),明显低于对照组的35.42%(17/48),差异有统计学意义(χ~2=4.381,P=0.036)。结论 RSI前预注右美托咪定不抑制呼吸功能,能使插管期间血流动力学维持平稳,减少并发症发生,值得临床推广应用。Objective To study the effects of priming dexmedetomidine before rapid-sequence induction（RSI）on intubation conditions and hemodynamics.Methods A total of 96 patients underwent general anesthesia for tracheal intubation in Department of Gynaecology of the hospital from July 2016 to June 2017 were divided into control group（48 cases）and observation group（48 cases）according to random number table method.The control group was given 10 mL 0.9%sodium chloride solution by pump injection,and the observation group was given rapid-sequence induction by pump injection of 0.6μg/kg dexmedetomidine,and the control group and observation group were given the same anesthesia operation and medicine.The heart rate（HR）,mean arterial pressure（MAP）,mean velocity of blood flow velocity,hemodynamic parameters and pulsation index,blood oxygen partial pressure（PaO2）and CO2 partial pressure（PaCO2）and complications were compared in two groups.Results The HR and MAP in observation group were lower than that in the control group,and the difference was statistically significant（P〈0.05）.The blood flow velocity,mean velocity and pulse index in observation group were lower than those in the control group,and the difference was statistically significant（P〈0.05）.The PaO2 and PaCO2 levels in observation group were lower than those in the control group,and the difference was statistically significant（P〈0.05）.The incidence of complications in observation group was 16.67%（8/48）which was significantly lower than 35.42%（17/48）in the control group,and the difference was statistically significant（χ~2=4.381,P=0.036）.Conclusion The priming dexmedetomidine before rapid-sequence induction cannot suppress respiratory function,maintain hemodynamic stability during intubation,reduce the complications,and it was worthy of clinical popularization and application.

关 键 词：快速序贯诱导 气管插管 右美托咪定 血流动力学 

分 类 号：R446.1[医药卫生—诊断学]