右美托咪啶对高血压病人甲状腺手术中血流动力学参数的影响

目的了解右美托咪啶对高血压病人甲状腺手术中血流动力学参数的影响。方法行单侧甲状腺手术的高血压病人80例，随机分为右美托眯啶组和对照组，每组40例。两组均采用双通道靶控丙泊酚复合舒芬太尼静脉全麻，右美托咪啶组于麻醉前15min泵注右美托眯啶1μg／kg，对照组给予等量生理盐水，观察给药前（T0）、手术切皮（T1）、剥离甲状腺上极（T2）、手术结束（T3）时两组病人的心率（HR）、平均动脉压（MAP）及术毕病人苏醒时间、拔管时间、拔管时RAMSAY评分。结果T1、T2、T3时右美托咪啶组HR、MAP较对照组明显降低（t=7．04～20．32，P〈0．05）；右美托咪啶组T0、T1、T2、T3时HR、MAP两两比较，差异有显著性（F=57．27、245．10，q=3．15～36．62，P〈0．05）；右美托咪啶组拔管时RAMSAY评分明显高于对照组（t=8．902，P〈0．0）；两组苏醒和拔管时间比较差异无统计学意义（P〉0．05）。结论麻醉前泵注右美托咪啶有利于高血压病人甲状腺手术中血流动力学参数的稳定，不影响苏醒和拔管时间，可减少术后躁动的发生。

THE EFFECT OF DEXMEDETOMIDINE ON HYMODYNAMIC IN HYPERTENSIVE PATIENTS UNDERGOING THYROIDECTOMY

Objective To observe the effect of dexmedetomidine on hemodynamics in hypertensive patients undergoing surgery for thyroid glands. Methods Eighty hypertensive patients undergoing unilateral thyroid surgery were equally randomized to dexmedetomidine group （group D） and control group （group C）. Patients in group D received a single dose of dexmedetomidine 1 f＇g/kg 15 minutes before general anesthesia. Those in the control group were given equivalent normal saline. The HR and MAP of patients before medication （T0）. at skin incision （T1）. thyroid dissection （T2）. upon completion of surgery （T3） were recorded. and recovery time. extubation time and RAMSAY score noted was well. Results HR and MAP in group D at T1, T2, and T3 were lower than group C （t=7.04-20.32.P〈0.05）. and in group D. the differences between two HR and MAP in different time points were significant （F=57.27 .245.10;q =3.15-36.62; P〈0.05）. The RAMSAY score in group D at extubation was higher than the control （t = 8.902. P〈0.0）. The differences between the two groups were not statistically significant in terms of time of coming around and extubation （P〉0.05）. Conclusion Dexmedetomidine infusion before anesthesia is conducive to stabilizing hemodynamics in hypertensive patients undergoing unilateral surgery for thyroid gland, which reduces postoperative agitation and does not impact the time of analepsia and extubation.