右美托咪啶作为静脉全麻药对妇科手术血流动力学的影响

目的探讨右美托咪啶替代丙泊酚对妇科手术术中血流动力学的影响。方法将腹腔镜下全子宫切除术患者40例随机分为盐酸右美托咪定组(A组)20例和丙泊酚组(B组)20例,A组:诱导剂量0.5μg/kg,10 min输注完毕,术中维持剂量2.5μg/(kg.h)。B组:诱导剂量1.0 mg/kg,术中维持剂量100μg/(kg.min)。记录麻醉前(T1)、麻醉诱导后(T2)、气管插管后即刻(T3)、手术开始时(T4)、手术开始后30 min(T5)、手术结束时(T6)时患者的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS)值及氧分压(SpO2)。结果与B组比较,除T1时点外,A组其余时点HR均显著下降(P<0.01),T4、T5、T6时SBP、DBP、MAP显著升高(P<0.05)。结论右美托咪定可替代丙泊酚用于维持腹腔镜手术的全凭静脉麻醉,麻醉过程平稳,镇静深度充分。

Influence of dexmedetomidine used as intravenous anaesthetics on haemodynamics in gynecologic surgery

Objective To explore the influence of dexmedetomidine on haemodynamics of gynecologic surgery by instead of propofol.Methods 40 patients with laparoscopic panhysterectomy were randomly divided into dexmedetomidine group(group A) and propofol group(group B).Group A: induced dose 0.5 μg/kg,infusion within 10 min,the maintenance dose during operation was 2.5 μg/(kg·h).Group B: induced dose 1.0 mg/kg,the maintenance dose during operation was 100 μg/(kg·min).The systolic pressure(SBP),diastolic pressure(DBP),mean arterial pressure(MAP),heart rate(HR),bispectral index(BIS) and partial pressure of oxygen(SpO2) were recorded at time points of pre-anesthesia(T1),after induction of anesthesia(T2),immediately after endotracheal intubation(T3),at the beginning of operation(T4),30 min after beginning of operation(T5) and the end of the operation(T6).Results Compared with group B,apart from T1,the HR decreased obviously at any other time points in group A(P<0.01),while the SBP,DBP,MAP at T4,T5,T6 increased obviously(P<0.05).Conclusion Dexmedetomidine instead of propofol in total intravenous anesthesia in laparoscopic surgery has a smooth anesthesia process and an adequate sedation.