摘要
目的 观察右美托咪定辅助硝酸甘油控制性降压在鼻内镜手术中的应用效果。方法 2012年4月-2013年2月,选择择期行鼻内镜手术的患者60例,ASAⅠ-Ⅱ级,随机分为硝酸甘油组（N组）和右美托咪定复合硝酸甘油组（DN组）,每组30例。记录麻醉前（T0）、手术开始前（T1）、降压15 min（T2）、降压30 min（T3）、和停止降压20 min（T4）各时点的MAP、HR、血乳酸（Lac）浓度及NT值,评估术野质量,并记录苏醒期躁动发生率等。结果 与T0时比较,N组MAP于T2、T3时降低（P〈0.05）,HR于T2-T4时加快（P〈0.05）,DN组MAP于T1-T3时降低（P〈0.05）,HR于T1时减慢（P〈0.05）;与N组比较,DN组MAP及HR于T1-T4时降低（P〈0.05）。与T0时比较,N组及DN组血乳酸于T2、T3时升高（P〈0.05）;DN组术野质量评分低于N组（P〈0.05）,苏醒期躁动发生率低于N组（P〈0.05）。结论右美托咪定辅助硝酸甘油控制性降压,术野理想,为鼻内镜手术一种较适宜的控制性降压方法。
Objective To observe the application effect of controlled hypotension with dexmedetomidine assisting nitroglycerin in endoscopic sinus surgery. Methods From April 2012 to February 2013,60 patients with ASA Ⅰ- Ⅱ grade who underwent endoscopic sinus surgery were selected and randomly divided into nitroglycerin group（group N） and Dex combined assist nitroglycerin group（group DN）,and there were 30 cases in each group.Mean arterial pressure（MAP）,heart rate（HR）,blood lactate（Lac） concentration and the numerical of Narcotrend（NT） value before anesthesia（T0）,before operation（T1）,15min（T2） and 30 min（T3） after reducing the pressure,20 min after stoping reducing the pressure（T4） were recorded,and surgical field quality was evaluated,and the incidence rate of agitation during awakening period was recorded respectively. Results Compared with T0,MAP was decreased at T2,T3（P〈0.05） and HR was speeded up at T2-T4（P〈0.05） in group N respectively;MAP at T1-T3, and HR at T1 in group DN was significantly decreased（P〈0.05）.Compared with group N,MAP and HR was decreased respectively at T1-T4 in group DN（P〈0.05）.Compared with T0,Lac was increased at T2,T3 in group N and group DN（P〈0.05）;Surgical field quality score and the incidence rate of agitation during awakening period was lower than that of group N respectively（P〈0.05）. Conclusion Controlled hypotension of Dex assisting nitroglycerin with ideal surgical field is more appropriate controlled hypotension method for endoscopic sinus surgery.
出处
《中国当代医药》
2015年第18期41-43,47,共4页
China Modern Medicine
关键词
右美托咪定
硝酸甘油
控制性降压
鼻内镜手术
Dexmedetomidine
Nitroglycerin
Controlled hypotension
Endoscopic sinus surgery
