摘要
【摘要J目的评价右美托眯啶对颅内动脉瘤患者围手术期血糖及儿茶酚胺的影响。方法选取我院2011年9月至2012年6月拟行颅内动脉瘤夹闭术患者60例（ASAⅡ～Ⅲ）。随机分成两组，每组30例。A组（右美组）麻醉诱导前缓慢静注1μg/kg右美托嘧啶，继以异丙酚，芬太尼，维库溴铵静脉推注，BIS值50～60开始气管插管。术中以异丙酚，瑞芬太尼，维库溴铵，异氟醚，0．4-0．7μg／（h·kg）右美托嘧啶麻醉维持。同时硝酸甘油控制性降压MAP50-60mmHg。B组（异丙酚组）麻醉诱导和维持不用右美托咪啶，余同A组。分别比较两组麻醉诱导前（T0）、气管插管后（T1）、切皮（T2）、钻颅骨（T3）、动脉瘤夹闭后（L4）、术后2h（T5）等各时间点的血糖及血浆儿茶酚胺水平。结果T0、、T3、L血浆儿茶酚胺A组较B组明显降低（P〈0．05），血糖水平在T2、T3和T5时间点A组显著低于B组（P〈0．05）。A组硝酸甘油用量明显少于B组（P〈0．01）。结论右美托咪啶可明显降低神经外科手术中患者儿茶酚胺的释放，避免血糖波动，减少血管扩张药的用量。
Objective To evaluate the effect of dexmedetomidine on blood glucose and catecholamine in pa- tients with intraeranial aneurysm after operation. Methods Sixty patients （ASA Ⅱ～Ⅲ） scheduled for clipping of in- tracranial aneurysm in our hospital from September 2011 to June 2012 were randomly divided into two groups, each with 30 cases. Group A received slow intravenous infusion of 1 μg/kg dexmedetomidine followed by propofol, fentan- yl, vecuroniurn bromide before induction of anesthesia, and then tracheal intubation at BIS 50-60. Propofol, remifent- anil, vecuronium, isoflurane, 0.4-0.7 μg/（h·kg） of dexmedetomidine were used for maintenance of anesthesia during operation, and nitroglycerin was applied to maintain MAP 50-450 mmHg. Group B （propofol group） did not applied dexmedetomidine for induction and maintenance of anesthesia. The blood glucose and plasma levels of catecholamine were compared between the two groups before induction of anesthesia （T0）, after tracheal intubation （T1）, skin incision （T2）, drilling skull （T3）, after aneurysm clipping （T4）, 2 hours after the operation （T5）. Results Plasma levels of cate- cholamine at T0, T2, T3, T5 in group A was significantly lower than those in group B （P〈0.05）, and blood glucose level at T2, T3, T5 of group A was significantly lower than those of group B （P〈0.05）. In group A, the dosage of nitroglycerin was obviously less than group B （P〈0.01）. Perioperative hemodynamics of group A was more stable than group B. Conclusion Dexmedetomidine can reduce catecholamine release in patients during neurosurgery, avoid the blood glucose fluctuation, and reduce the vasodilator drug dosage.
出处
《海南医学》
CAS
2013年第17期2538-2540,共3页
Hainan Medical Journal
关键词
右美托咪啶
儿茶酚胺
血糖
颅内动脉瘤
Dexmedetomidine
Catecholamine
Blood glucose
Intracranial aneurysms
