盐酸右美托咪定联合阿托品对老年患者心率变异性的影响

目的观察盐酸右美托咪定联合阿托品对老年患者心率变异性的影响。方法选择40例择期行单侧髋关节置换术的老年患者,年龄60岁-85岁,ASAⅡ-Ⅲ级,随机分为二组：静脉注射阿托品0.5mg组（AD组,n=20）;生理盐水对照组（D组,n=20）。3分钟后两组均给予盐酸右美托咪定（0.5μg/Kg.h）静脉泵入,维持至手术结束前30分钟。记录心率变异性指标：基础值（T0）、输注右美托咪定5分钟（T1）和10分钟后（T2）的HR、LF、HF及LF/HF。结果在给药后T1及T2时间点,D组的HR、LF、HF及LF/HF分别与T0时刻相比均下降,差异有统计学意义（P〈0.05）;AD组的HR、LF、HF及LF/HF分别与T0时刻相比无统计学差异（P〉0.05）;D组的HR、LF、HF及LF/HF与AD组相比较均明显降低（P〈0.05）。结论盐酸右美托咪定能降低老年患者心率变异性的相关指标,联合使用阿托品后对老年患者的心率变异性无明显影响,可预防心动过缓等不良反应的发生。

The effect of Dexmedetomidine with atropine on heart rate variability in old patients

Objective To investigate the effect of Dexmedetomidine with and without Atropine on heart rate varia- bility in old patients. Methods Forty ASA Ⅱ-Ⅲ old patients ,aged 60 to 85 years, undergoing elective unilateral hip replacement surgery were randomly divided into two groups：intravenous atropine 0.5 mg group （AD group, n = 20）; saline control group （D group,n=20）. Three minutes later,the two groups were given intravenous infusion of dexme- detomidine （0- 5μg/Kg, h） maintained until a0 minutes before the end of surgery~ The heart rate variability indicators such as HR,LF, HF,and LF/HF were recorded before and at 5,10 rain after intravenous infusion of dexmedetomidine ; Results Compared with T0,the HR,LF,HF,and LF/HF of D group were significantly decreased （P〈0. 05）; the HR,LF,HF and LF/HF in AD group had no significant difference compared with TO （P〉0.05）; The HR,LF, HF, and LF/HF of D group were lower than AD group（P〈0.05）. Conclusion Dexmedetomidine can reduce the heart rate variability indicators in 01d patients. Combined with Atropine has no significant effect on heart rate variability in old patients and can prevent the occurrence of adverse reactions such as bradycardia.