不同剂量右美托咪定对全麻气管插管心血管反应的影响

目的观察静脉持续输注不同剂量右美托咪定对全身麻醉气管内插管期心血管反应的影响。方法 ASAⅠ～Ⅱ级,全麻下择期手术的患者60例,随机分为低剂量组(Y1组)、中剂量组(Y2组)和高剂量组(Y3组)。麻醉诱导前,三组静脉持续泵入右美托咪定(溶于NS至20 mL),剂量分别为0.2、0.5、0.8μg/kg,且均在10 min内完成。麻醉诱导药物相同。记录三组患者泵注前(基础值)、泵注后5 min、插管时、插管后1、2、5、15 min各时刻的收缩压(SBP)、舒张压(DBP)、平均动脉压(M AP)和心率(HR)。结果输注右美托咪定后,三组患者的SBP、DBP、MAP、HR均呈下降趋势,且Y3组患者HR在右美托咪定输注完毕时下降最明显(P<0.05);插管时,Y1组患者的SBP、M AP、HR高于基础值(P<0.05),并高于同时刻的Y2、Y3组(P<0.05),而Y2、Y3组各指标较基础值无明显变化。气管插管后15 min内,三组患者的SBP、DBP、M AP、HR逐渐下降到基础值附近,尤其是在插管后15 min,SBP、DBP、MAP、HR显著低于基础值(P<0.05),组间比较差异无统计学意义。结论中剂量右美托咪定对全身麻醉气管内插管期心血管反应有较好的控制作用。

Effects of different doses of dexmedetomidineon on cardiovascular response to endotrachael intubation

Objective To observe the effects of different doses of dexmedetomidineon on cardiovascular response to endotrachael intubation.Methods Sixty patients,ASA classⅠorⅡ,undergoing elective surgery w ith general anesthesia w ere randomly divided into low dose dexmedetomidine group(Y1 group),middle dose dexmedetomidine group(Y2 group) and high dose dexmedetomidine group(Y3 group).Before the induction,patients of the three groups received continuous infusion of different doses of dexmedetomidine(dissolved by NS to 20 mL) : 0.2,0.5,0.8 μg / kg.The continuous infusion finished in 10 min.All patients got the same anesthetics for induction.The parameters of systolic blood pressure(SBP),diastolic pressure(DBP),mean arterial pressure(M AP),heart rate(HR) w ere recorded at the following moment: initial the dexmedetomidine infusion(foundation values),5 min after infusion,intubation immediately,1,2,5 and 15 minutes after intubation.Results After continuous infusion of dexmedetomidine,parameters of SBP,DBP,M AP and HR of all patients decreased,especially the HR of patients in group Y3(P < 0.05) at the moment of dexmedetomidine infusion w as finished.During tracheal intubation,the SBP,DBP,M AP and HR of patients in group Y1 were higher than foundation values and those of patients in group Y2,group Y3(P < 0.05).But at this time,these parameters in group Y2 and group Y3 w ere similar to their initial values.From the endotracheal intubation even to 15 min,parameters of SBP,DBP,M AP and HR of patients in the three groups decreased to the foundation values,particularly at 15 min after intubation respectively(P < 0.05),but there was no significant difference between three groups.Conclusion Continuous infusion of middle dose of dexmedetomidine could well control the cardioascular response to trachealintubation of patiens undergoing general anesthesia during surgery procedures.