摘要
目的观察右美托咪啶对全身麻醉患者术中迷走神经活动性的影响。方法选择静吸复合全身麻醉下行口腔颌面外科手术的患者50例,ASAⅠ~Ⅱ级,分为试验组(D组)和对照组(C组),每组25例。D组诱导前静脉泵注右美托咪啶1μg/kg 10 min,C组泵注等量生理盐水。记录术前(T 0)、插管(T 1)、术中(T 2)时段的脑电双频指数(BIS)、平均动脉压(MAP)、心率(HR)及心率变异性(HRV)分析指标。结果与T 0时比较,T 1时两组MAP、HR均明显升高(P<0.05),T 1时D组的MAP、HR、BIS均明显低于C组(P<0.05)。与C组相比,D组在T 1时,所有窦性RR间期的标准差(SDNN)、logLF、低频功率/高频功率(LF/HF)、散点图长轴(SD2)明显降低;T 2时,所有邻近窦性RR间期长度差异的均方根(RMSSD)、logHF、散点图短轴(SD1)、心率减速力(DC)明显升高(P<0.05),LF/HF明显降低(P<0.05),logLF无明显变化(P>0.05)。结论右美托咪啶作为麻醉辅助药物对围术期自主神经活动有调控作用。
Objective To observe the effect of dexmedetomidine on the vagal nerve activity in the patients with general anesthesia.Methods A total of 50 patients with elective oral and maxillofacial surgery under intravenous-inhalation combined general anesthesia,the ASA gradeⅠ-Ⅱ,were selected and divided into the experimental group(group D)and control group(group C),25 cases in each group.Group D was given dexmedetomidine 1μg/kg by intravenous injection pump at 10 min before induction,while group C was intravenously pumped with the same amount of normal saline.BIS,MAP,HR and indicators of heart rate variability were recorded at preoperation(T 0),intubation(T 1)and intraoperation(T 2).Results The MAP and HR of the two groups were significantly increased at T 1 as compared with those at T 0(P<0.05).The MAP,HR and BIS at T 1 in group D were significantly lower than those in group C(P<0.05).Compared with group C,the SDNN,logLF,LF/HF and SD2 in group D were significantly deceased at T 1;the RMSSD,logHF,SD1 and DC at T 2 were significantly increased at T 2(P<0.05),while LF/HF was significantly decreased(P<0.05),and logLF had no significant change(P>0.05).Conclusion Dexmedetomidin as an auxiliary drug of anesthesia has an regulatory effect on autonomic nervous activity in perioperation.
作者
杨思雨
房怿
刘洪霞
申岱
YANG Siyu;FANG Yi;LIU Hongxia;SHEN Dai(Department of Anesthesiology,Stomatology Hospital of Tianjin Medical University,Tianjin 300070,China)
出处
《重庆医学》
CAS
2019年第21期3681-3684,共4页
Chongqing medicine
关键词
右美托咪啶
心率变异性
迷走神经
全身麻醉
dexmedetomidine
heart rate variability
vagus nerve
general anesthesia
