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|本期目录/Table of Contents|

右美托咪定对高血压病患者全麻苏醒期的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第2期
页码:
202-204,209
栏目:
临床研究
出版日期:
2015-11-25

文章信息/Info

Title:
Clinical research on the effect of dexmedetomidine on patients with essential hypertension during emergence from general anesthesia
作者:
王显望; 陈 剑; 王恒林; 吕宝胜; 徐 震; 王卓强
(解放军第309医院麻醉科，北京 100091)
Author(s):
WANG Xian-wang;  CHEN Jian;  WANG Heng-lin;  L? Bao-sheng;  XU Zhen;  WANG Zhuo-qiang
(Department of Anesthesiology, PLA 309 Hospital, Beijing 100091, China)
关键词:
右美托咪定; 芬太尼; 全身麻醉; 高血压; 原发性; 气管拔管
Keywords:
dexmedetomidine;  fentanyl;  general anesthesia;  essential hypertension;  tracheal extubation
分类号:
R444.1; R782.05
DOI:
-
文献标识码:
A
摘要:
目的 观察右美托咪定对高血压病患者全麻苏醒期的影响。方法 选取在全麻下行颈椎手术的高血压病患者60例，随机均分为右美托咪定组（试药组，D组）和对照组（C组），于术毕前10 min分别泵入右美托咪定0.5 μg/kg和芬太尼1 μg/kg。观察麻醉前（T0）、术毕前10 min(T1)、 术毕时(T2)、拔管前即刻 (T3)、拔管后5 min和10 min(T4、T5)时HR、SBP和DBP值。记录T5时Ramsay镇静评分和 VAS疼痛评分及苏醒期不良反应的发生情况。结果 试药组T2时心率显著低于T1时（P<0.05）；对照组T3、T4时HR、SBP均高于麻醉前（P<0.05或P<0.01）；试药组T3~T5时HR、SBP和DBP值均显著低于对照组（P<0.05或P<0.01）。试药组Ramsay镇静评分显著高于对照组（P<0.05）。两组术后VAS评分无显著差异。试药组苏醒期时呛咳、躁动发生率低于对照组（P<0.05）。结论 高血压病患者全麻结束前静脉给予小剂量的右美托咪定能够减轻苏醒期血流动力学波动，可减少不良反应的发生率。
Abstract:
AIM To observe the effects of dexmedetomidine on emergence from general anesthesia in patients with essential hypertension. METHODS Sixty patients with essential hypertension undergoing cervical vertebral surgery were randomly divided into group D and group C (30 cases each), respectively, receiving 0.5 μg/kg dexmedetomidine and 1 μg/kg fentanyl at 10 min before the completion of surgery. Heart rate (HR), systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) were recorded before anesthesia (T0), 10 min before the completion of surgery (T1), after the completion of surgery (T2), 1 min before extubation (T3), and 5 and 10 min after tracheal extubation (T4, T5). VAS pain score was evaluated and Ramsay sedation score was recorded at T5. Incidences of cough, agitation and shivering were also recorded during emergence. RESULTS In group D, HR at T2 was lower than that at T1 (P<0.05). HR and SBP in group C at T3 and T4 were higher than those in group C at T0 (P<0.01, P<0.05). HR, SBP and DBP in group D were lower than those in group C at T3, T4 and T5 (P<0.05, P<0.01). No statistical difference was observed in VAS pain score between groups. Ramsay score in group D was higher than in group C. Incidences of agitation and cough in group D were lower than those in group C during the emergence period (P<0.05). CONCLUSION Dexmedetomidine (0.5 μg/kg) given to patients with essential hypertension before the completion of surgery could reduce hemodynamic fluctuation, decrease the risk of adverse reaction and provide more safety during the emergence period.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2015-02-03.
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
更新日期/Last Update: 2016-04-25