雾化右美托咪定降低气管插管后血流动力学反应的前瞻性随机研究  

A Prospective Randomized Study of Nebulized Dexmedetomidine to Reduce Hemodynamics Response after Tracheal Intubation

作　　者：闫国中 贺伟忠 张雷光 钱刚 吕复君 YAN Guo-zhong;HE Wei-zhong;ZHANG Lei-guang;QIAN Gang;LU Fu-jun(Department of Anesthesiology,Kaifeng Central Hospital,Kaifeng 475000,China)

机构地区：[1]开封市中心医院麻醉科,开封475000

出　　处：《中国合理用药探索》2021年第11期77-80,共4页Chinese Journal of Rational Drug Use

基　　金：开封市科技攻关计划项目(2103044);河南省医学科技攻关计划(联合共建)项目(LHGJ20191177)。

摘　　要：目的:基于右美托咪定具有经口鼻生物利用度高、吸收快的优点,开展以雾化右美托咪定的给药方式降低气管插管血流动力学反应的前瞻性随机研究。方法:纳入2020年1月~2020年12月期间本院60例择期需行气管插管的全身麻醉患者为研究对象,采用随机数字表法分为观察组和对照组,每组30例。在全身麻醉诱导前10 min,观察组给予右美托咪定雾化吸入治疗,对照组给予0.9%氯化钠溶液。记录雾化前(T_(0))、雾化后(T_(1))、气管插管即刻(T_(2))、插管后1 min(T_(3))和插管后3 min(T_(4))的收缩压(SBP)、舒张压(DBP)、心率(HR)和各时刻血清中皮质醇(COR)、肾上腺素(AD)、去甲肾上腺素(NE)的水平。结果:T_(1)~T_(4)时期,观察组的SBP、DBP和HR水平均低于对照组(P<0.05);COR、AD、NE的浓度均低于对照组(P<0.05);两组均出现呛咳、低血压、窦性心动缓等症状,但组间比较无统计学差异(P>0.05)。结论:雾化右美托咪定能有效减轻气管插管时的应激反应,无不良反应。Objective:Based on the advantages of high oral and nasal bioavailability and fast absorption of dexmedetomidine,a prospective randomized study was conducted to reduce the hemodynamics response of tracheal intubation by nebulized dexmedetomidine.Methods:From January to December 2020,a total of 60 patients with general anesthesia who were scheduled to undergo tracheal intubation in our hospital were selected as the research subjects,and were divided into the observation group and the control group,with 30 cases in each group.10 min before induction of general anesthesia,the observation group was given dexmedetomidine nebulized inhalation treatment,while the control group was given 0.9%sodium chloride solution.Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and the levels of serum cortisol(COR),adrenaline(AD)and noradrenaline(NE)were recorded before nebulization(T_(0)),after nebulization(T_(1)),immediately after tracheal intubation(T_(2)),1 min after intubation(T_(3))and 3 min after intubation(T_(4)).Results:The levels of SBP,DBP,and HR at T_(1)~T_(4) in the observation group were lower than those in the control group(P<0.05).The concentrations of cortisol(COR),epinephrine(AD)and norepinephrine(NE)in the observation group were lower than those in the control group(P<0.05).Both groups presented symptoms such as choking,hypotension and sinus bradycardia,but there was no statistical difference between the two groups(P<0.05).Conclusion:Nebulized dexmedetomidine can effectively reduce the stress response during tracheal intubation without any adverse reactions.

关 键 词：右美托咪定 气管插管 血流动力学 应激反应 雾化 

分 类 号：R971[医药卫生—药品] R614[医药卫生—药学]