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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2014年第4期

页码:

477-479

栏目:

临床研究

出版日期:

2014-04-25

文章信息/Info

Title:

Effect of dexmedetomidine on hemodynamics in hypertensive patients during endotracheal intubation

作者:

王显望; 刘 峰; 王恒林; 徐 震; 吕宝胜; 王卓强

(解放军第309医院麻醉科，北京100091)

Author(s):

WANG Xian-wang;  LIU Feng;  WANG Heng-lin;  XU Zhen;  LV Bao-sheng;  WANG Zhuo-qiang

(Department of Anesthesiology, PLA 309 Hospital, Beijing 100091, China)

关键词:

右美托咪定; 全身麻醉; 气管插管; 血流动力学

Keywords:

dexmedetomidine;  general anaesthesia;  tracheal intubation;  hemodynamics

分类号:

R971

DOI:

-

文献标识码:

A

摘要:

目的:观察右美托咪定对高血压患者全麻诱导气管插管时血流动力学影响。方法： 选取40例需气管插管全麻手术的高血压病患者, 随机分为试药组和对照组（每组20例），分别在麻醉诱导前10 min泵入右美托咪定1 μg /kg和生理盐水。记录给药前（基础值T0）、给药后（T1）、麻醉诱导后（T2）、插管后即刻（T3）、插管后3 、5 和10 min（T4、T5、T6）时患者心率(HR)、收缩压(SBP)、舒张压(DBP)和脑电双频指数（BIS）的变化。记录麻醉诱导时丙泊酚的用量。结果: 对照组T3、T4时HR、SBP和DBP均比T0时显著升高（P<0.05，P<0.01）。试药组T3~T5时HR、SBP和DBP分别与T0时比较无显著差异。试药组T3、T4时HR、SBP和DBP显著低于对照组同一时间点（P<0.05，P<0.01）。试药组在T5时HR和SBP显著低于对照组同一时间点（P<0.05）。诱导时试药组丙泊酚用量(113±22) mg显著低于对照组(140±25) mg（P<0.01）。试药组T1时BIS值(73±4)显著低于C组(97±2)（P<0.01）。结论: 麻醉诱导前给予右美托咪啶1 μg/kg能显著抑制气管插管时血流动力学反应，减少诱导时丙泊酚用量。

Abstract:

AIM:To observe the effect of dexmedetomidine on hemodynamics in hypertensive patients during endotracheal intubation. METHODS: Forty hypertensive patients receiving tracheal intubation under general anaesthesia were randomly allocated into two groups (20 cases each), and group D and group C, respectively, received dexmedetomidine (1 μg/kg) and saline. Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and bispectral index (BIS) were recorded, respectively, before drug administration (baseline; T0), after drug administration (T1), after induction of anesthesia (T2), immediately after intubation (T3) and 3, 5 and 10 min after intubation (T4, T5, and T6). The dosages of propofol used during anesthesia induction were recorded. RESULTS: In group C, HR, SBP and DBP at T3 and T4 were higher than those at T0 (P<0.05, P<0.01). In group D, there were no significant differences in HR, SBP and DBP between at T3, T4, T5, and at T0. At T3 and T4, HR, SBP and DBP in group D were lower than those in group C at the same time point (P<0.05, P<0.01). At T5, HR and SBP in group D were lower than those in group C (P<0.05). During anesthesia induction, the dosages of propofol in group D (113±22) mg were significantly lower than those in group C (140±25) mg (P<0.01). At T1, the value of BIS in group D (73±4) was significantly lower than that in group C (97±2) (P<0.01). CONCLUSION: Dexmedetomidine (1 μg/kg) given 10 min before anesthesia induction significantly attenuates the hemodynamic response to tracheal intubation and reduces the dosages of propofol during anesthesia induction.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2014-02-11.通讯作者：王卓强，主任医师，主要从事麻醉基础与临床研究 Email：zhuoqiang30@hotmail.com 作者简介：王显望，主治医师，博士生 Email：ww309xx@hotmail.com

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更新日期/Last Update: 2014-05-06