摘要
目的探讨右美托咪定对乳腺癌患者术中麻醉药物用量的影响。方法选择60例ASAⅠ～Ⅱ择期乳腺癌手术患者，随机将其均分为右美托咪定组（观察组）和对照组，分别记录两组患者术中丙泊酚和瑞芬太尼的用量，入手术室后（T0）、诱导前（T1）、插管后1分钟（T2）、手术30min（T3）、手术结束（T4）、拔管后5min（T5）时的平均动脉压（MAP）、心率（HR）及脑电双频指数（BIS）的变化。术中芬太尼用量按标准换算成瑞芬太尼量。结果观察组患者丙泊酚的用量较对照组明显减少29％[2．0（1．3～3．4）vs3．1（2．2～4．7）mg／（kg·h），P＝0．005）]，瑞芬太尼的用量也明显减少[0．16（0．09～0．21）vs0．10（0．07～0．15）μg／（kg·h），P＝0．03]。术中两组患者MAP、HR及BIS值未见统计学差异（P＞0．05）。结论右美托咪定复合全麻可明显减少乳腺癌患者术中丙泊酚和瑞芬太尼的用量，两组患者围术期不良反应未见统计学差异。
[Objective]To explore whether dexmedetomidine can reduce the requirement for propofol and remifentanil during breast cancer operation .[Methods]A total of 60 American Society of Anesthesiologists physical status Ⅰ ~ Ⅱ patients received either dexmedetomidine （1 μg/kg over 10 min followed by a continuous infusion of 0 .4 μg/kg/h until tumor removal） or comparable volumes of saline as a placebo .Propofol and remifentanil require‐ments were recorded and analyzed .Changes in mean arterial pressure ,heart rate and bispectral index （BIS） were recorded at operation room （T0 ） ,before anesthesia induction （T1 ） ,1 min pre‐intubation （T2 ） ,30 min during sur‐gery （T3 ） ,end of surgery （T4 ） and 5 min post‐extubation （T5 ） .[Results]All patients completed the study .The propofol dosage required for anesthetic maintenance was 29% （with a 95% confidence interval ,18~40） and it was lower in patients on dexmedetomidine [2 .0 （1 .3~ 3 .4） vs 3 .1（2 .2~4 .7） mg/（kg · h） ,P = 0 .005] .And remifentanil dosages were also significantly different [0 .16（0 .09~0 .21） vs 0 .10（0 .07~0 .15）μg/（kg·h） ,P=0 .03] .The incidence of adverse events ,including hemodynamic instability and delayed recovery ,was comparable with and without dexmedetomidine .[Conclusion]Dexmedetomidine administration significantly reduces the re‐quirement for both propofol and remifentanil during anesthetic induction and maintenance .
出处
《医学临床研究》
CAS
2015年第1期97-99,共3页
Journal of Clinical Research
