摘要
目的观察右美托咪啶(dexmedetomidine,DXM)用于预防全身麻醉气管插管心血管反应的效果。方法将ASAⅠ-Ⅱ级、无异常手术麻醉史,心电图、肝肾功能及电解质正常、拟在全身麻醉下行择期手术的30例患者,按随机数字表法分为2组,右美托咪啶组和对照组,每组15例。右美托咪啶组静脉泵注右美托咪啶1μg.kg-1,10 min泵注完;对照组则静脉泵注等量的生理盐水。2组诱导用药均为咪唑安定0.1 mg.kg-1、芬太尼4μg.kg-1、维库溴铵0.1 mg.kg-1及依托咪酯0.3 mg.kg-1。对2组给药前、给药后、插管前、插管时,插管后1、3、5 min的收缩压(SBP)、舒张压(DBP)、心率(HR)的变化进行比较。结果 2组患者插管时、插管后1 min的BP、HR与给药前、给药后、插管前比较均有不同程度升高,但右美托咪啶组的升高程度明显低于对照组(P<0.01);右美托咪啶组的HR在给药后、插管前,插管后3、5 min较给药前明显下降(均P<0.01)。右美托咪啶组有1例患者给药后出现显著的心动过缓,经给予阿托品0.5 mg后恢复至正常。结论右美托咪啶能显著减轻气管插管时的心血管反应,维持血流动力学的稳定。
Objective To observe the effects of dexmedetomidine on cardiovascular response to tracheal intubation during general anesthesia.Methods Thirty patients（ASA classⅠ-Ⅱ） scheduled for elective operations under general anesthesia,who had normal physical examination（electrocardiogram,liver and kidney function and electrolytes） without a history of anesthesia exception,were randomly assigned to receive either intravenous infusion of 1μg·kg-1 dexmedetomidine（dexmedetomidine group,n=15）or intravenous infusion of the same amount of normal saline（controlled group,n=15）.Anesthesia was induced with midazolam 0.1 mg·kg-1,fentanyl 4 μg·kg-1,vecuronium 0.1 mg·kg-1 and etomidate 0.3 mg·kg-1 in both groups.Systolic blood pressure（SBP）,diastolic blood pressure（DBP） and heart rate（HR） were recorded before infusion,after infusion,before intubation,during intubation,and 1,3 and 5 minutes after intubation.Results Blood pressure（BP） and HR increased during intubation and 1 minute after intubation in both groups（P0.01）,but the increase in dexmedetomidine group was smaller than that in control group（P0.01）.After infusion,before intubation,and 3 and 5 minutes after intubation,HR significantly decreased in dexmedetomidine group,compared with the control value and the value before infusion（P0.01）.Bradycardia occured in 1 patient after dexmedetomidine infusion,but reverted to normal after administration of 0.5 mg atropine.Conclusion Dexmedetomidine can effectively reduce cardiovascular responses to tracheal intubation during general anesthesia.
出处
《南昌大学学报（医学版）》
CAS
2010年第11期37-39,共3页
Journal of Nanchang University：Medical Sciences
关键词
右美托咪啶
气管插管
心血管反应
dexmedetomidine
tracheal intubation
cardiovascular responses
