右美托咪定对颅脑手术拔管期血流动力学的影响

目的观察不同剂量右美托咪定在颅脑手术拔管期对血流动力学的影响。方法 48例患者随机均分为右美托咪定0.4、0.6、0.8μg/kg组(D1、D、D3组)和生理盐水组(C组)。手术结束前分别给予不同剂量右美托咪定和等容量生理盐水。记录给药前(T1)、给药后10min(T2)、15min(T3)、拔管前(T4)、拔管时(T5)和拔管后1min(T6)的MAP、HR、SpO2;记录苏醒期血管活性药使用情况。结果与C组比较,D1、D2和D3组在拔管期间血流动力学较平稳,但D3组血管活性药物使用较多。结论术毕前给予右美托咪定0.4μg/kg和0.6μg/kg可有效维持颅脑手术拔管时血流动力学的稳定,且不延长拔管时间。

Effects of dexmedetomidine on hemodynamics during extubation after intracranial surgery

Objective To observe the effects of different doses of dexmedetomidine on hemodynamics during extubation after intracranial surgery.Methods Forty-eight patients were randomly divided into four groups: dexmedetomidine 0.4 μg/kg (group D1), 0.6 μg/kg (group D2), 0.8 μg/kg (group D3) and control group (group C). Different doses of dexmedetomidine and the same volume of normal saline were given before the end of surgery. Mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) were monitored before the dexmedetomidine administration (T1), 10 min (T2) and 15 min (T3) after the administration, before extubation (T4), at the time of extubation (T5) and 1 min after extubation (T6). The administration of vasoactive drugs during emergence were recorded.Results Compared with group C, groups D1, D2 and D3 were all better for stabilizing the hemodynamics during extubation, but group D3 used more vasoactive drugs.Conclusion Dexmedetomidine 0.4 μg/kg and 0.6 μg/kg administered before the end of intracranial surgery can stabilize the hemodynamics without prolonging the time to extubation during extubation period.