摘要
目的探讨右美托咪定复合舒芬太尼对腹腔镜胆囊切除术患者血流动力学影响。方法选择择期行腹腔镜胆囊切除术患者60例,美国麻醉医师协会身体状况分级为Ⅰ～Ⅱ级,随机将患者分为右美托咪定复合舒芬太尼组(复合组)和舒芬太尼组,每组30例。2组麻醉诱导静脉注射舒芬太尼0.5μg.kg-1、丙泊酚1.5 mg.kg-1、维库溴铵0.15 mg.kg-1。复合组诱导时静脉泵注1.0μg.kg-1右美托咪定(15 min内泵完),舒芬太尼组按相同方法给予等容量生理盐水。诱导后行气管内插管,2组麻醉维持相同。监测并记录麻醉前(T0),插管后1 min(T1),气腹后3(T2)、8(T3)、18 min(T4)及术毕清醒期(T5)各时段平均动脉压(MAP)、心率(HR)情况。记录丙泊酚、舒芬太尼用量,记录2组患者气腹期间高血压、低血压、心动过速及心动过缓发生率。结果与T0相比,舒芬太尼组患者T1～T3、T5时MAP值明显上升、HR加快(P<0.05);复合组患者各时段MAP值变化不明显(P>0.05),HR减慢(P<0.05)。复合组T1～T5各时段MAP、HR值显著低于舒芬太尼组(P<0.05);高血压及心动过速发生率低于舒芬太尼组(P<0.05);丙泊酚及舒芬太尼用量小于舒芬太尼组(P<0.05)。结论全身麻醉诱导时右美托咪定1.0μg.kg-1开始静脉泵注(15 min)复合舒芬太尼在腹腔镜胆囊切除术中可维持血流动力学更平稳。
Objective To study the effect of dexmedetomidine combined with sufentanil on hemodynamics of patients undergoing laparoscopic cholecystectomy. Methods Sixty patients undergoing laparoscopic choleeystectomy, ASA I - II , were randomly divided into dexmedetomidine combined with sufentanil group （composition group） and sufentanil group ,30 eases in each group. Two groups were administered intravenous injection sufentanil 0.5 μg · kg^-1 ,propofol 1. 5 mg· kg^-1 and vecuronium 0.15 mg · kg^-1 in sequence. Dexmedetomidine with 1.0 μg · kg^-1 was administered intravenously within 15 mi- nutes in composition group, synchronization induction and the same volume normal saline was given in sufentanil group in the same way. Endotraeheal intubation was administrated after induction, the maintenance of anesthesia was same in the two groups. Mean arterial pressure （MAP） and heart rate （ HR ） were monitored and recorded at these points-before anesthesia （TO ）, 1 minute after intubation （T1）,3 minutes after pneumoperitoneum （T2 ）,8 minutes after pneumoperitoneum （T3 ）, 18 minutes after pneumoperitoneum （ T4 ） , awaking after surgery （ T5 ）. The dosage of propofol and sufentanil were recorded. The incidence of hypertension, hypotension, tachycardia, bradycardia of two groups were recorded during pneumoperitoneum as well. Results Compared with To, MAP significantly increased at TI -T3 -T5 in sufentanil group and HR accelerated （P 〈 0. 05 ） ; there were not significant differences in MAP at each point （ P 〉 0.05 ） , but the HR decelerated（ P 〈 0.05 ） in composi- tion group. Compared with sufentanil group, MAP and HR were significantly lower, the incidence of hypertension and tachycar- dia was lower ,the dosage of propofol and sufentanil was less at each point in composition group （ P 〈 0.05 ）. Conclusion Dexmedetomidine with 1.0 μg · kg^-1 of induction and injecting（ 15 minutes） sufentanil can maintain the intraoperative hemo- dynamics more smoothly during dparoscopie cholecystectomy.
出处
《新乡医学院学报》
CAS
2013年第9期752-754,共3页
Journal of Xinxiang Medical University
