盐酸右美托咪定预防颈丛阻滞在甲状腺手术中的心血管不良反应

目的：观察盐酸右美托咪定预防颈丛麻醉下甲状腺手术患者心血管不良反应的效果。方法：将60例甲状腺手术患者随机分为两组,Ⅰ组为盐酸右美托咪定组（30例）,Ⅱ组为0.9%氯化钠对照组（30例）。观察并记录两组患者麻醉前（T0）、颈丛阻滞完毕后10min（T1）、颈丛阻滞完毕后20min（T2）、颈丛阻滞完毕后30min（T3）、术毕（T4）SBP、DBP和HR的变化,并于T0、T3、T4时抽取肘静脉血,用放免法测定血浆肾上腺素、内皮素、血管紧张素-Ⅱ的水平。结果：盐酸右美托咪定组术中HR、SBP、DBP较平稳,对照组在麻醉后HR、SBP、DBP明显升高,差异有统计学意义（P〈0.05或P〈0.01）,血浆肾上腺素、内皮素、血管紧张素-Ⅱ水平Ⅱ组较Ⅰ组明显升高,两组SpO2无明显变化。结论：盐酸右美托咪定治疗颈丛麻醉下甲状腺手术患者的心血管反应安全、有效。

Effect of dexmedetomidine hydrochloride on cardiovascular reactions of cervical plexus block

Objective：To investigate the effect of dexmedetomidine hydrochloride on cardiovascular reactions of cervical plexus block. Methods：Sixty cases suffering from hyperthyroidism were divided into two groups at random; Group of dexmedetomidine hydrochloride （30 cases） ansaline was used in control group （30 cases）. And then before cervical anesthesia（T0）,10 min after cervical anesthesia（T1）,20 min after cervical anesthesia （T2）,30 min after cervical anesthesia （T3）,systolic pressure （SBP）,diastolic pressure （DBP） and heart rate（HR） were delected. Blood were taken from peripheral venus and centrifuged to extract blood serum at T0,T3 and T4. Contents of adrenalin,endothelin,angiotensin were measured with radio immunoassay. Results：The SBP,DBP and HR were relatively stable in operation of dexmedetomidine hydrochloride group. At T1,T2,T3 andT4,SBP、DBP and HR were clearly higher in control group than in dexmedetomidine hydrochlor ide group （P〈0.05 or P〈0.01）. The level of adrenalin,endothelin,angiotensinⅡin Ⅱgroup was higher thanⅠ group. Conclusion：Dexmedetomidine hydrochloride is effective and safe on cardiovascular reactions of cervical anesthesia.