右美托咪定用于抑制气管插管诱发心血管反应的效果观察

目的观察右美托咪定用于抑制气管插管心血管反应的效果。方法选取70例气管插管全麻择期行腹部手术的患者,采用信封法随机分为2组,每组35例。对照组患者静脉滴注生理盐水,观察组患者输注右美托咪定,采用丙泊酚及芬太尼静脉注射进行麻醉诱导,吸入2%七氟醚进行麻醉维持。观察组患者在麻醉诱导前静脉泵注盐酸右美托咪定。详细记录注药前(基础值)、输注右美托咪定或生理盐水后(用药后)、插管即刻、插管后1 min、3 min、5 min各时间点两组患者的收缩压(SBP)、舒张压(DBP)、心率(HR)。同时记录观察组患者静脉注入右美托咪定的不良反应。结果两组患者用药前SBP、DBP、HR比较差异无统计学意义(P>0.05)。用药后、插管即刻及插管后1 min,观察组SBP、DBP、HR均上升,但差异无统计学意义(P>0.05)。插管后3 min、5min,观察组SBP、DBP、HR降低(P<0.05),两组比较差异有统计学意义(P<0.05)。观察组2例(5.71%)出现不良反应,均为心动过缓,静注阿托品0.5 mg后心率恢复正常。结论在气管插管全麻手术患者诱导麻醉前应用右美托咪定,可显著减轻气管插管时的心血管反应,使患者血流动力学及心血管系统更加稳定。

Observation of the effect of dexmedetomidine on suppressing cardiovascular respon-ses induced by tracheal intubation

Objective To observe the effect of dexmedetomidine on suppressing the cardiovascular responses induced by tracheal intubation. Methods 70 cases of general anesthesia for elective abdominal surgery were randomly divided into two groups using envelope method,35 cases in each group. Control group was infused normal saline intra-venously with the same dose of dexmedetomidine used in observation group. The propofol and fentanyl anesthesia were induced with intravenous injection,and the inhalation of 2% sevoflurane was needed for maintenance of anesthesia. Pa-tients in observation group received anesthesia intravenous infusion of dexmedetomidine before induction. The systolic blood pressure （SBP）,diastolic blood pressure （DBP） and heart rate （HR） were recorded before injection （base-line） ,after infusion of dexmedetomidine or saline （ after treatment） ,at 0 min,1 min,3 min and 5 min after intubation. The adverse reactions were observed. Results Before treatment,there was no significant difference in SBP,DBP,HR between the two groups （P＆gt;0. 05）. The SBP,DBP and HR of observation group increased slightly after treatment and at 0 min,1 min after intubation without significant difference （P＆gt;0. 05）;but the SBP,DBP and HR of observation group decreased significantly at 3 min,5 min after intubation （P〈0. 05）,there were significant differences between the two groups （P〈0. 05）. There were 2 cases （5. 71%） of bradycardia in observation group,and the HR of the two pa-tients was recovered after intravenous injection of atropine 0. 5 mg. Conclusion The use of dexmedetomidine before induction of anesthesia for patients undergoing general anesthesia,can significantly reduce cardiovascular response to tracheal intubation,with more stable hemodynamics and cardiovascular system.