摘要
目的观察高血压患者全麻持续输注右美托咪定对血流动力学的影响。方法拟在静～吸复合麻醉下行甲状腺手术患者40例，高血压1或2级，ASAⅡ或Ⅲ级，术前SBP控制在160mmHg以下，随机分为两组，全麻诱导前10min持续微量泵注右美托咪定0．3μg·kg-1·h-1（D组）或生理盐水（C组）。术中维持BIS在40～50。记录入室时（T0）、插管前1min（T1）、插管后2min（T2）、切皮后2min（T3）、拔管即刻（T4）、入PACU后（T5）的SBP、DBP和HR，以及入PACU后5min行Ramsay镇静评分和疼痛VAS评分。结果与T0时比较，T4时两组HR明显减慢（P〈0．05）。T1、T2时C组SBP、DBP明显高于D组（P〈0．05）。C组降压药物使用率明显高于D组（45％VS．10％，P〈0．05）。D组Ramsay镇静评分明显高于C组（P〈0．05）。结论高血压患者全麻诱导前开始持续输注小剂量右美托咪定，可以提供适当的镇静、镇痛作用，同时更有助于控制高血压，提高手术麻醉安全性，降低不良反应发生率。
Objective To study the hemodynamic effects of low dose continuous dexmedetomidine infusion on patients with hypertension undergoing general anesthesia. Methods A total of 40 patients with hypertension, scheduled for thyroidectomy under inhalational combined with intravenous anesthesia, were randomly divided into two groups. Group D received 0.3μg·kg-1·h-1 of dexmedetomidine intravenously for 10 minutes before surgery. Group C received the same volume of 0. 9% saline. During maintenance of anaesthesia, BIS wore maintained between 40-50. SBP, DBP and HR were recorded at entering operating room （T0）, 1 min before intubation （T1）, 2 min after intubation（T2 ）, 2 min after skin incision（T3 ）, extubation（T4 ） and entering PACU（T5 ）and Ramsay scores, VAS pain scores were compared at 5 rain after entering PACU. Results HR was significantly diminished at T4 compared with T0 （P〈0.05）in two group, and the SBP, DBP in group C were significantly higher than in group D at T1, T2 （P〈0.05）. The use rate of antihypertensive agents in group C was significantly higher than in group D（45% vs. 10% ,P〈0. 05）. Ramsay sedation scores in group D was higher than in group C at T5 （P 〈0.05 ）. Conclusion Low dose continuous dexmedetomidine infusion for patients with hypertension can provide more satisfactory sedative, and analgesia effects without complications.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第12期1181-1183,共3页
Journal of Clinical Anesthesiology
