术前应用右美托咪定对妇科患者全麻诱导期心率变异性的影响

目的探讨术前应用右美托咪定对妇科患者全麻诱导期心率变异性的影响。方法根据右美托咪定剂量随机分为3组,分别为0.3μg/kg组(B组)、0.5μg/kg组(C组)和静脉泵入等量生理盐水对照组(A组),每组30例。记录患者入室5 min后的平均动脉压(MAP)、心率(HR)和HRV的频域分析指标:高频(HF)、低频(LF)及低频/高频(LF/HF),记录时间点为(T_0)。三组患者分别随机给予0.3、0.5μg/kg右美托咪定和等量生理盐水,给药结束5 min后,记录上述指标,时间点为T_1。三组患者均给予舒芬太尼0.2μg/kg、丙泊酚2 mg/kg、顺式阿曲库铵0.15 mg/kg进行麻醉诱导,3 min后气管插管。分别记录插管前及插管后即刻的观察指标,记录时间点分别为T_2、T_3。结果与T_0时比较时,A组和B组的LF值在T_2、T_3时明显升高(P<0.05);B组和C组HF值在T_2、T_3时明显升高(P<0.05);A组LF/HF值在T_3时明显增高(P<0.05),C组LF/HF值在T3时明显降低(P<0.05)。与A组、B组比较,C组LF值和LF/HF值在T3时明显降低(P<0.05)。结论0.5μg/kg的右美托咪定进行术前干预,能够降低交感神经的兴奋性,改善交感/迷走神经的平衡状态,稳定心血管功能

Effect of preoperative application of dexmedetomidine on heart rate variability in gynecological patients during anesthesia induction period

Objective To study the effect of preoperative application of dexmedetomidine on heart rate varia-bility in gynecological patients during anesthesia induction period. Methods According to the doses of dexmedetomi-dine,patients were randomly divided into three groups,0. 3 μg/kg group ( group B) ,0. 5 μg/kg group ( group C) and control group ( group A) ,in which the same amount of normal saline was pumped in by the vein,30 patients in each group. The MAP,HR,relative low frequency (LF),relative high frequency (HF),and the ratio of low frequency to high frequency power ratio ( LF/HF) were recorded at 5 min after entering into the operating room ( T0 ) . All the pa-tients were randomized to receive 0. 3 and 0. 5 μg/kg of dexmedetomidine and the same amount of saline solution;the above indicators were 5 min after the administration ( T1 ) . Patients in the three groups were given recorded 0. 2 μg/kg sufentanil,2 mg/kg propofol and 0. 15 mg/kg cisatracurium as anesthesia induction, and endotracheal intubation was given after 3 min. The observation indexes were recorded before intubation ( T2 ) and immediately after intubation ( T3 ) . Results Compared with T0 ,LF values of group A and group B and HF values of group B and group C were significantly increased at T2 and T3(P<0. 05). LF/HF values of group A were significantly increased at T3,while it decreased in group C at T3(P<0. 05). Compared with group A and group B,LF and LF/HF values of group C were significantly decreased at T3 ( P<0. 05 ) . Conclusion Preoperative intervention with 0. 5 μg/kg of dexmedetomidine can reduce the excitability of sympathetic nerve,improve the balance state of sympathetic/vagus nerve and stabilize the cardiovascular function.