右美托咪定对快通道心脏麻醉诱导过程中血流动力学的影响

目的：探讨右美托咪定应用于心脏手术患者快通道心脏麻醉诱导时对血流动力学的影响。方法：入选2012年1月～2013年12月于我院择期通过快通道心脏麻醉进行心脏手术治疗的患者52例，根据入院先后顺序分为两组，各26例，对照组行常规诱导麻醉，观察组于诱导前加用右美托咪定麻醉，比较两组患者在麻醉和插管各时点的血流动力学情况及不良反应的发生情况。结果：观察组注射右美托咪定后心率明显低于对照组，差异具有统计学意义（P〈0．05）；两组各时点血压值差异较大，观察组变化较为平稳，插管前血压平稳下降，插管后血压平稳上升，而对照组插管前血压下降变化较大，插管后上升变化较大，与观察组比较差异均具有统计学意义（P均〈0．05）；观察组心动过缓发生率为11．5％（3／26），对照组为7．7％（2／26），观察组低血压发生率为19．29／6（5／26），对照组为15．4％（4／26），两组差异无统计学意义（P〉0．05）。结论：心脏手术患者快通道心脏麻醉诱导前应用右美托咪定可显著减轻麻醉诱导所致的血压下降及气管插管所致的血压上升，提高循环稳定性。

Impact of dexmedetomidine on haemodynamics during process of fast track cardiac anesthesia induction

Objective. To discuss the impact of dexmedetomidine on haemodynamics during the process of fast tract cardiac anesthesia induction. Methods： A total of 52 patients with fast tract cardiac anesthesia induction for cardiac surgeries from January 2012 to December 2013 were chosen and divided into 2 groups by half according to admission order. Control group was given routine induction of anesthesia while observation group was given dexmedetomidine before induction of anesthesia. Conditions of haemodynamits at different time points during anesthesia and intubation and occurrences of complications of the 2 groups were compared. Results： After injection of dexmedetomidine, HR of observation group dropped significantly and was significantly lower than control group （P〈0.05） ; there were significant differencesin BP between two groups at different time points. Changes of observation group were stable, before intubation BP declined stably and after intubation BP inclined stably, but in control group, before intubation BP declined with large changes and after intubation BP inclined with large changes. Compared with observation group, the differences were all significant （all P〈0.05）. Occurrence rate of bradycardia of observation group was 11.5% （3/26） while control group was 7.7% （2/26）, occurrence rate of hypotension of observation group was 19.2% （5/26） while control group was 15.4% （4/26） （all P〉0.05）. Oonclusion. Application of dexmedetomidine before fast tract cardiac induction of anesthesia for patients with cardiac surgeries can obviously relieve BP drop caused by anesthesia induction and BP rise caused by intubation and increase cycling stability.