小剂量右美托咪定对全身麻醉高血压患者血流动力学及麻醉效果的影响

探讨小剂量右美托咪定对全身麻醉高血压患者血流动力学的影响，以及麻醉镇静效果。方法：选择符合标准的患者80例，随机分为观察组和对照组各40例，两组患者均采用相同的麻醉方法，观察组患者全麻诱导前10min持续静脉微量泵入右美托咪定0．3μg· kg-1· h-1，对照组患者给予等量的0．9％氯化钠注射液。观察两组患者入室时（T0）、插管前1min（T1）、插管即刻（T2）、插管后2min（T3）、拔管前1min（T4）、拔管后2min（T5）的血流动力学变化、RSS镇静评分及不良反应等。结果：两组患者手术时间、术中出血量、术中胶体入量、术中晶体入量、术中尿量、麻醉时间、拔管时间、苏醒时间及不良反应发生率相似，差异无统计学意义（ P＞0．05）。观察组患者T1、T2、T3、T4、T5时收缩压（SBP）、舒张压（DBP）、心率（HR）较T0时均下降，差异有统计学意义（P＜0．05）；对照组患者T1时SBP、DBP、HR较T0时均下降，但是T2、T3、T4、T5时SBP、DBP、HR较T0时均上升，差异有统计学意义（P＜0．05）；两组患者T0、T1时SBP、DBP、HR相似，差异无统计学意义（P＞0．05），但是对照组T2、T3、T4、T5时SBP、DBP、HR高于观察组，差异有统计学意义（ P＜0．05）。观察组患者T1、T2、T3、T4和T5时RSS镇静评分均高于对照组，差异有统计学意义（ P＜0．05）。结论：小剂量右美托咪定能抑制高血压患者全身麻醉拔管、插管等应激反应，提供适当的镇静作用，有助于血流动力学的稳定，提高手术麻醉安全性。

Effects of a Small Dose of Dexmedetomidine on the Anesthesia Effects and Hemodynamics in Patients with Hypertension Under General Anesthesia

To investigate the effect of a small dose of dexmedetomidine on the hemodynam-ics and the sedation and anesthesia effects in patients with hypertension under general anesthesia .Method：80 eligible patients were selected and randomly divided into observation group and control group , 40 patients in each group;the patients of the two groups used the same anesthesia method , the patients of the observa-tion group were continuously intravenously micro-pumped with 0.3 μg · kg-1 · h-1 of dexmedetomidine , while the patients of the control group were given with equivalent 0.9%sodium chloride injection .The hemo-dynamic changes , Ramsay sedation scores （ RSS ） and adverse reactions in the patients of the two groups when entering the room （ T0 ） , 1min before intubation （ T1 ） , 0min after intubation （ T2 ） , 2min after intuba-tion （ T3 ） , 1min before extubation （ T4 ） and 2min after extubation were observed .Result： The operative times, intra-operative blood losses , intra-operative colloid infusion volumes , intra-operative crystalline in-fusion volumes , intra-operative urine volumes , anesthesia times , extubation times , palinesthesia times and adverse reaction incidences in the patients of the two groups were similar , and the differences were statistical-ly insignificant （P〉0.05）.In the patients of the observation group , the systolic blood pressures （SBP）, di-astolic blood pressures （ DBP ） and heart rates （ HR） at T1 , T2 , T3 , T4 and T5 were decreased when com-pared with those at T 0 , and the differences were statistically significant （ P〈0.05）; while in the patients of the control group , the SBP , DBP and HR at T 1 were decreased when compared with those at T 0 , but the SBP, DBP and HR at T2, T3, T4 and T5 were increased when compared with those at T 0, and the differences were statistically significant （ P〈0.05）;the SBP , DBP and HR at T 0 and T1 in the patients of the two groups were similar, and the differences were statistically insignificant