摘要
目的:观察右旋美托咪定对神经外科介入手术患者血流动力学的影响。方法:选择60例ASA分级3～4级择期神经外科血管瘤手术患者,于气管内插管全身麻醉下行DSA介入栓塞治疗,随机分为A组(对照组)和B组(实验组),A组常规麻醉诱导与维持,B组先在10 min内静脉泵注负荷量右旋美托咪定1μg/kg(如患者年龄>65岁则负荷量为0.8μg/kg),然后以0.2～0.6μg(kg.h)速度持续泵注并进行麻醉诱导与维持,术毕拔管后或出DSA室前停用右旋美托咪定,观察右旋美托咪定对麻醉诱导、气管插管即时、术毕拔管时血流动力学的影响,同时观察两组患者术后恢复情况及心脑血管并发症。结果:A组:与基础值[MAP(105.2±25.7)mm Hg(1 mm Hg=0.1333 kPa),HR(89.7±16.4)次/min]比较,气管插管即时[MAP(128.6±23.9)mmHg,HR(97.9±18.4)次/min]、术毕拔管时[MAP(131.5±22.3)mm Hg,HR(98.7±19.9)次/min]的MAP及HR均有升高(P<0.05);B组:与基础值[MAP(102.9±27.4)mm Hg,HR(86.9±17.6)次/min]比较,各时段MAP、HR[气管插管即时MAP(109.1±26.3)mm Hg,HR(88.2±17.7)次/min;术毕拔管时(MAP 110.4±19.8)mm Hg,HR(89.5±18.3)次/min]均无明显变化(P>0.05);两组比较,A组气管插管即时、术毕拔管当时的MAP及HR与B组比较均有升高(P<0.05),各时段SpO2比较差异均无统计学意义(P>0.05);两组患者恢复情况及心脑血管并发症比较差异无统计学意义(P>0.05)。结论:右旋美托咪定能有效地减少麻醉诱导和拔管期的应激反应,维持血流动力学的稳定。
Objective To observe the effects of dexmedetomidine on hemodynamics in patients underwent neurosurgical intervention surgery.Method Total 60 patients undergoing scheduled interventional surgeries of hemangioma were assigned to two groups,the experimental group（goup A） and the control group（group B） randomly.Group A underwent routine anesthesia,group B was administrated with dexmedetomidine 1 μg/kg as a bonus in 10 min（bonus was 0.8 μg/kg if patients′ age65 years）.After that,dexmedetomidine was administrated 0.2~0.6 μg/（kg·h） during the anesthesia,and stopped before extubation or transferring to wards.Affects to hemodynamics were recorded at time points of induction,intubation and extubation,and recoveries and complications of patients were also recorded.Results MAP and HR in group A increased statistically at intubation and extubation timepoint comparing with baseline（P0.05）,and those showed no statistical differences in group B（P0.05）.MAP and HR increased statistically in group A comparing with group B（P0.05）.There were no statistical differences in recoveries and complications between the two groups（P0.05）.Conclusion Demedetomidine can decrease the hemodynamical fluctuations in induction and extubation period of interventional neurosurgeries.
出处
《吉林医学》
CAS
2011年第34期7260-7262,共3页
Jilin Medical Journal
