小剂量右美托咪定在经尿道输尿管镜钬激光碎石术中的应用  

Low-dose dexmedetomidine in transurethral ureteroscopic holmiumlaser lithotripsy

作　　者：杨勇[1] 葛建岭[1] 王伟[1] 徐成[1] YANG Yong;GE Jian-ling;WANG Wei;XU Cheng(Department of Anesthesiology,Chuzhou First People＇s Hospital,Chuzhou,Anhui 239000,China)

机构地区：[1]滁州市第一人民医院麻醉科,滁州安徽239000

出　　处：《中国临床研究》2018年第8期1068-1071,共4页Chinese Journal of Clinical Research

摘　　要：目的观察小剂量右美托咪定在经尿道输尿管镜钬激光碎石术中的应用效果。方法选2017年1月至2018年1月气管插管全麻下行经尿道输尿管镜钬激光碎石术患者84例,随机分为3组,每组28例。麻醉诱导前10 min,高剂量组给予右美托咪定1μg/kg;低剂量组给予右美托咪定0.5μg/kg;对照组输注生理盐水10 ml。记录和比较三组输注前(T1)、诱导后(T2)、气管插管时(T3)、插管后1 min(T4)、气管拔管时(T5)的平均动脉压(MAP)、心率(HR),比较三组患者呼吸恢复时间、睁眼时间、气管拔管时间及麻醉期间和麻醉后的不良反应。结果三组患者呼吸恢复时间比较差异无统计学意义(P>0.05)。高剂量组睁眼时间、气管拔管时间明显长于低剂量组和对照组,差异有统计学意义(P<0.05);低剂量组与对照组比较无统计学差异(P>0.05)。高剂量组、低剂量组T2、T3、T4、T5时MAP、HR均低于T1时(P<0.05);对照组T2时MAP、HR均低于T1时(P<0.05),但T3、T4、T5时MAP、HR均高于T1、T2时(P<0.05)。T1、T2时,三组MAP、HR比较无统计学差异(P>0.05);T3、T4、T5时高、低剂量组MAP、HR均低于对照组(P<0.05)。低剂量组、对照组低血压、心动过缓发生率明显低于高剂量组(P<0.05);低剂量组不良反应总发生率明显低于高剂量组和对照组(P<0.05)。结论在经尿道输尿管镜钬激光碎石术全麻诱导前应用右美托咪定0.5μg/kg能使麻醉维持平稳,不良反应少。Objective To observe the application effect of low dose dexmedetomidine on transurethral ureteroscopic holmium laser lithotripsy. Methods Eighty-four patients with transurethral ureteroscopic holmium laser lithotripsy under general anesthesia with tracheal intubation from January 2017 to January 2018 were randomly divided into three groups（n =28,each）. Dexmedetomidine of different doses was given 10 minutes before induction of anesthesia respectively in group D1（1 μg/kg） and group D2（0. 5 μg/kg）,and normal saline 10 ml was given in group M as control. Mean arterial pressure（MAP）,heart rate（HR） were recorded and compared before Dexmedetomidine infusion（T1）,after anaesthesia induction（T2）,during tracheal intubation（T3）,1 min after intubation（T4）,tracheal extubation（T5）,and the recovery time,eyeopening time,extubation time and the adverse reaction during and after anesthesia were recorded and compared among three groups. Results There was no significant difference in respiratory recovery time between the three groups（P〉0. 05）. The time of eye opening and tracheal extubation time in group D1 were significantly longer than those in group D2 and group M（P〈0. 05）,however,there were no significant differences in them between group D2 and group M（P〉0. 05）. MAP and HR at T2,T3,T4 and T5 were significantly lower than those at T1 in group D1 and D2（P〈0. 05）. MAP and HR at T2 were significantly lower than those at T1 in group M（P〈0. 05）. MAP and HR at T3,T4,T5 were significantly higher than those at T1 and T2（P〈0. 05）. There were no significant differences in MAP and HR at T1 and T2 among three groups（P〈0. 05）. MAP and HR were significantly lower at T3,T4,T5 in group D1,D2 than those in group M（P〈0. 05）. The incidence of hypotension and bradycardia in group D2 and group M were significantly lower than those in group D1（P 0. 05）,and the incidence of adverse reactions in group D2 was significantly lower than that in group D1 and group

关 键 词：右美托咪定 输尿管镜钬激光碎石术 经尿道 麻醉 不良反应 

分 类 号：R614[医药卫生—麻醉学]