持续输注右美托咪啶对全麻插管期心血管反应的影响

目的观察静脉持续输注右美托咪啶对全身麻醉气管内插管期心血管反应的影响.方法 ASAⅠ～Ⅱ级,全麻下择期手术的病人40例,随机分为对照组（D组）和右美托咪啶组（Y组）.麻醉诱导前,D组静脉持续泵入生理盐水（NS）20 mL,Y组持续静脉泵入右美托咪啶（0.5μg/kg,溶于NS至20 mL）,均在10min内完成;麻醉诱导药物相同.记录两组患者泵注NS或右美托咪啶前（基础值）、泵注后5 min、10 min,插管时、插管后1 min、2 min、5 min、10 min、15 min各时刻的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）和心率（HR）.结果输注NS或右美托咪啶后,两组患者的SBP、DBP、MAP、HR均呈下降趋势,且Y组患者HR在右美托咪啶输注完毕时下降最明显（P〈0.05）;插管时,D组患者的SBP、MAP、HR显著高于基础值（P〈0.05）,并高于同时刻的Y组（P〈0.05）,而Y组各指标较基础值无明显变化.气管插管后15min内,两组患者的SBP、DBP、MAP、HR逐渐下降到基础值附近,尤其是在插管后10 min、15 min SBP、DBP、MAP、HR显著低于基础值（P〈0.05）,组间比较无明显差异.结论右美托咪啶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 Continuous Infusing Dexmedetomidine on Cardiovascular Response to Endotrachael Intubation of Patients Undergoing General Anesthesia

Objective To observe the effects of continuous infusion of dexmedetomidine on cardiovascular response to endotrachael intubation of patients underwent surgery with general anesthesia. Methods Forty patients, ASA class Ⅰ or Ⅱ , undergoing elective surgery with general anesthesia were randomly divided into control group （D） and dexmedetomidine group （Y）. Before the induction, patients in group D received continuous infusion of N.S （20 mL） , those patients in group Y for dexmedetomidine 0.5 μg/kg （dissolved by N.S to 20 mL） , and 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 （MAP） , heart rate （HR） of every patient were recorded at the following moment： initial the dexmedetomidine or N.S infusion （foundation values） , five and 10 min after infusion; intubation immediately, 1 min, 2min, 5 min, 10 min and 15 min after intubation. Results After continuous infusion of N.S or dexmedetomidine, parameters of SBP, DBP, MAP and HR of all patients decreased, especially the HR of patients in group Y （P 〈 0.05） at the moment of dexmedetomidine infusion was finished. During tracheal intubation, the SBP, DBP, MAP and HR of patients in group D were significantly higher than foundation values and those of patients in group Y （P 〈 0.05 ）. But at this time, these parameters in group Y were similar to their initial values. From the end of tracheal intubation even to 15 min, parameters ofSBP, DBP, MAP and HR of patients in both two groups were decreased to the foundation values, particularly at 10min and 15 min after intubation （P 〈 0.05） respectively, but there was no difference between two groups. Gonelusion Continuous infusion of dexmedetomidine could well control the cardioascular response to tracheal intubation of patiens undergoing general anesthesia during surgery procedures.