盐酸右美托咪定在胸腔镜手术患者中的应用

目的观察右美托咪定对胸腔镜手术患者血流动力学的影响。方法择期行胸腔镜下肺叶切除手术患者40例。随机分成生理盐水组（C组）和右美托咪定组（D组）,每组20例。麻醉诱导开始时两组患者分别静脉泵注生理盐水或右美托咪定。观察两组入室时（T1）、插管时（T2）、吸痰时（T3）、拔管时（T4）、拔管后5min（T5）的SBP、DBP、HR的变化及拔管期间患者呛咳和躁动的情况。结果两组患者T2的SBP、HR无明显差异（P〉0.05）,但均明显高于T1（P〈0.05）。C组T3、T4、T5的SBP、HR明显高于D组（P〈0.05）;D组的拔管时间比C组延长（P〈0.05）,D组呛咳、躁动评分明显低于C组（P〈0.01）。结论右美托咪定用于胸腔镜手术,能稳定术中及苏醒期的血流动力学,并减少拔管期的应激反应与呛咳和躁动。

The study of dexmedetomidine in patients undergoing thoracoscopic surgery

Objective To observe the hemodynamic effects of dexmedetomidine been used in patients undergoing thoracoscopic surgery. Methods 40 patients undergoing thoracoscopic lobectomy：of lung were randomly divided into 2 groups =0. 9% normal saline（C group, n=20 ） and dexmedetomidine（D group,n=20）. At the beginning of anesthesia induction,patients between two groups were intravenous injected the saline or dexmedetomidine continuously. To ob- serve changes of SBP,DBP, H R of patients at entering the operating room （T1）, intubation （T2）, sputum suction（Ta ）, extubation（T4 ）,after extubation 5 min （T5） and cough, restlessness of patients during wake extubation between two groups. Results There were significantly higher SBP, HR at T2 than that at T1 in both groups（P〈0.65）. There were significantly SBP, HR at T3 ,T4 ,T5 ,higher in C group than in D group（P〈0.05）. Extubation period,There were sig- nificantly lower cough scores and agitation scores in D group than in C group （P〈0.01） ;Conclusion Dexmedetomidine in patients undergoing thoracoscopic lobectomy of lung could keep a stable hemodynamic state during operative pe- riod and awake extubation period,and reduce stress response, cough and agitation in patients.