摘要
目的观察右美托咪定全麻诱导期血流动力学及眼内压的影响。方法选择择期全麻气管插管手术48例。采用随机数字表法随机分为咪达唑仑组(M组)和右美托咪定0.6μg/kg组(D1组)、1.0μg/kg组(D2组),每组16例。麻醉诱导:M组给予咪达唑仑,D1、D2组分别给予不同剂量右美托咪定,采用微量泵按预定剂量持续输注10 min,7 min时依次静脉注射芬太尼、维库溴铵及依托咪酯,3 min后气管插管。监测麻醉诱导前(T0),气管插管前(T1),气管插管后1 min(T2)、3 min(T3)、5 min(T4)时眼内压(IOP)、平均动脉压(MAP)及心率(HR)。记录诱导过程中不良反应发生情况。结果 IOP 3组T1时均较T0降低(P<0.05),M组T2～4时较T1明显增高(P<0.01),D1、D2组T1～4时均较M组降低(P<0.05)。D1组HR及D2组MAP、HR T1时均较T0时降低(P<0.05),M组MAP、HRT2～4时均较T1明显增高(P<0.05),D1、D2组MAP、HR T1～4时均较M组降低(P<0.05),D2组HR明显低于D1组(P<0.05)。M组高IOP发生率高于D1和D2组(P<0.01),D1和D2组低IOP以及心动过缓发生率均高于M组(P<0.05,P<0.01),且D2组高于D1组(P<0.01)。结论 0.6μg/kg右美托咪定可以较好地抑制气管插管引起的血流动力学及IOP的波动,使诱导过程更加平稳。
Objective To investigate the influences of Dexmedetomidine on intraocular pressure and hemodynamics during induction period of general anesthesia.Methods A total of 48 patients who would undergo endotracheal intubation with general anesthesia were randomly divided into Midazolam group（n = 16,group M）,and Dexmedetomidine（0.6 μg /kg） group（n = 16,group D1） and Dexmedetomidine（1 μg /kg） group（n = 16,group D2）.Anesthesia induction： group M was treated with midazolam,while group D1 and D2 pumped with different dose of Dexmedetomidine for 10 min of continuing infusion.At 7th min anesthesia was induced intravenously in turn of Fentanyl,Vecuronium and Etomidate,and 3 min later intubation was performed.The intraocular pressure（IOP）,mean arterial pressure（MAP） and heart rate（HR） were detected before anesthesia（T0）,before intubation（T1）,at 1 min（T2）,at 3 min（T3） and at 5 min（T4） after intubation.Adverse reactions during the induction were recorded.Results IOP of the three groups at T0 were lower than those at T1（P 0.05）,IOP of group M at T2-4 were significantly higher than those at T1（P 0.01）,and IOP of group D1 and Group D2 were lower than those of group M at T1-4（P 0.05）.HR of group D1,and MAP and HR of group D2 at T1 were lower than those at T0（P 0.05）,MAP and HR of group M at T2-4 were significantly higher than those at T1（P 0.05）,MAP and HR of group D1 and group D2 at T1-4 were lower than those of group M（P 0.05）,and HR of group D2 was significantly lower than that of group D1（P 0.05）.The incidence of high IOP in group M was significantly higher than that of group D1 or group D2（P 0.01）,the incidences of low IOP and bradycardia in group D1 and group D2 were higher than those in Group M（P 0.05,P 0.01）,and the incidence of low IOP and bradycardia in group D2 were high than those in group D1（P 0.01）.Conclusion Dexmedetomidine 0.6 μg /kg pumping can inhibit fluctuations of hemodynamics and IOP which caused by the tracheal intub
出处
《解放军医药杂志》
CAS
2013年第3期69-71,共3页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
关键词
右美托咪定
血流动力学
眼内压
Dexmedetomidine
Hemodynamics
Intraocular pressure
