右美托咪定对妇科腹腔镜手术全身麻醉气管插管期心血管反应的影响

目的观察右美托咪定预防妇科腹腔镜手术全身麻醉气管插管期心血管应激反应的效果。方法将80例择期妇科腹腔镜手术行全身麻醉气管插管患者随机为两组：右美托咪定治疗组（D组，n=40）和对照治疗组（N组，n=40）。麻醉诱导前10min静脉泵注右美托咪定（1ug／kg）或等容量等速度注射0．9％氯化钠溶液。比较诱导前（T1）、诱导后（气管插管前）（T2）、气管插管后即刻（T3）及插管后1min（T4）、3minfT5）的血流动力学变化。结果在T2时，D组平均动脉压（MAP）为（81.3±5．9）mmHg，心率（HR）为（54．9±2．5）次／min，N组MAP为（71．5±4．7）mmHg，HR为（65-3±3．1）次／分，与T1比较显著降低，差异有统计学意义（P〈0．05）；与N组比较，D组MAP在12、rr4、T5均显著升高，差异有统计学意义（P〈0．05）；D组HR在1、2、T3、T4、T5时则明显降低，差异有统计学意义（P〈0．05）。结论右美托咪定可安全有效地减少妇科腔镜手术患者全身麻醉诱导及气管插管期间的血流动力学波动，减轻心血管应激反应。

Effect of dexmedetomidine on cardiovasclular response to tracheal intubation after general anesthesia for gynecological laparoscopic surgery

Objective To investigate the effects of dexmedetomidine on cardiovascular response to tracheal intubation undergoing general anesthesia for gynecological laparoscopic surgery. Methods A total of 80 patients scheduled for laparoscopic surgery were randomized into two groups：dexmedetomidine group （group D, n=40） and control group（group N, n=40）. Dexmedetomidine（lug/kg） or equal volume of saline was given at 10min before induction of anesthesia. The mean arterial pressure （MAP）and heart rate （HR） concentration were compared before induction of anesthesia （T1）, after induction of anesthesia （T＇2）, immediately after intubation （T3）, and lmin after intubation （T4）, 3min after intubation （T5）. Results MAP was 81.3± 5.9 （ mmHg ）, HR was 54.9±2.5 （ beat/min ）, In group D at T2,MAP was 71.5± 4.7 （ mmHg ）, HR was 65.3± 3.1 （ beat/min ） , In group N at T2,they were significantly lower than that at T1 and therewas statistical significance between T2 and T1 （P〈0.05）.Compared with group N,MAP at T2,T4,and T5 increased （P〈0.05）, and HR at T2,T3,T4,T5 decreased in group D（P〈0.05）. Conclusions Dexmedetomidine is efficient and secure to control the fluctuation of haemodynamics in laparoscopic gynecological surgery.