摘要
目的研究不同右美托咪定剂量对全身麻醉下慢性鼻窦炎鼻息肉患者手术围拔管期应激反应的影响。方法选择首都医科大学石景山教学医院北京市石景山医院全麻状态下接受鼻内镜手术的患者90例,分为A、B、C组,每组各30例。手术结束前15 min,A、B、C组分别泵注0.3、0.6、0.9μg/kg右美托咪定。记录并比较三组患者各项临床指标。结果 B组的Ramsay镇静评分高于A组,拔管质量评分低于A组,C组的唤醒、拔管时间均长于A组和B组,Ramsay镇静评分高于A组和B组,拔管质量评分低于A组;A组手术结束时(T2)、拔管时(T3)和拔管后10 min(T4)的肾上腺素(E)、去甲肾上胰素(NE)、皮质醇(Cor)浓度均高于给药前(T1),B、C组T3、T4时刻的E、NE、Cor浓度均低于A组;A组T2、T3时刻的心率(HR)、平均动脉压(MAP)均高于T1时刻,B、C组T2、T3、T4时刻的HR、MAP均低于A组,以上差异均有统计学意义(P<0.05)。结论鼻内镜手术患者手术结束前15 min泵注0.6μg/kg右美托咪定可以较好的维持血流动力学,抑制应激反应。
Objective To study the dexmedetomidine dose applied under general anesthesia in patients with chronic sinusitis and nasal polyps stress response during tracheal extubation. Methods 90 cases of patients, who were selected fornasal endoscopic surgery under general anesthesia, were divided into A, B, the C groups, each group 30 cases. 15 min before the end of surgery,A group were given dexmedetomidine 0.3 μg / kg,B group 0.6 μg / kg, and C group 0.9μg / kg. Recorded and compared the three groups of patients with the clinical indicators. Results Ramsay sedation score of group B was higher than that of group A; extubation quality score was lower than that of group A. Wake-up time and extubation time of group C were longer than those in group A and group B; Ramsay sedation score was higher than that of group A and group B; extubation quality score was lower than that of group A.E, NE and Cor concentrations of T2,T3 and T4 time points of group A were higher than that of T1 time point, but higher than that of group B and C at the same corresponding time. HR and MAP of group A at time points T2 and T3 were higher than that of T1, but were higher than those of group B and C at T2, T3 and T4 time points.The above differences were statistically significant（P〈0.05）. Conclusion 15 min before the end of nasal endoscopic surgery infusion of dexmedetomidine 0.6 μg / kgcan better maintain hemodynamics and inhibit the stress response.
出处
《热带医学杂志》
CAS
2015年第9期1246-1247,1251,共3页
Journal of Tropical Medicine
关键词
右美托咪定
全身麻醉
鼻内镜手术
应激反应
dexmedetomidine
general anesthesia
the nasal endoscopic surgery
stress response
