期刊文献+

右旋美托咪定用于神经外科动脉瘤介入手术的临床观察

下载PDF
导出
摘要 目的探讨右旋美托咪定对神经外科动脉瘤介入手术患者术中应激和术毕苏醒质量的影响。方法选择神经外科动脉瘤介入手术患者90例,年龄22-65岁,其中男44例,女46例,术前ASAⅡ-Ⅳ级,随机分为2组:生理盐水对照组为C组,右旋美托咪啶组为D组,每组45例。D组患者入室开放静脉通道后开始泵注负荷量1.5μg/kg右旋美托咪定,诱导后持续泵注维持量右旋美托咪定(0.5-0.7)μg/(kg·h)维持至手术结束;C组泵注等体积生理盐水至手术结束。分别于入手术室时(T1)、股动脉穿刺(T2)、置放导丝开始(T3)、手术结束(T4)、气管拔管即刻(T5)和拔管后10min(T6)等时刻点,观察并记录患者心率(HR)和平均动脉压(MAP)、围手术期不良事件发生情况、气管拔管时间苏醒期躁动发生率。并于T1-T6时刻点抽取患者颈内静脉测血浆肾上腺素(AE)、去甲肾上腺素(NE)、多巴胺(DA)的浓度。结果在T1和T3时刻点,两组患者HR、MAP比较差异无统计学意义(P>0.05);在T2,T4-T6时刻点,D组患者HR、MAP明显低于对照组(P<0.05)。在T1时刻点,两组患者血浆AE、NE、DA水平比较无差异(P>0.05)。在T2-T6时刻点,两组患者血浆AE、NE、DA水平呈上升趋势,且C组明显高于D组(P<0.05)。两组患者围术期不良事件发生率比较无统计学差异(P>0.05);C组患者拔管时间和苏醒期躁动明显高于D组(P<0.05)。结论右旋美托咪定对神经外科动脉瘤介入手术患者,可以降低患者应激水平,缩短患者术后拔管时间,提高患者的苏醒质量。
出处 《江西医药》 CAS 2015年第11期1271-1274,共4页 Jiangxi Medical Journal
  • 相关文献

参考文献9

  • 1Lee CZ,Young WL. Anesthesia for endovascular neurosurgery and interventional neuroradiology [J]. Anesthesiol Clin,2012,30 (2) : 127-147.
  • 2张冉,罗猛强,侯炯.颅内动脉瘤血管内介入手术的麻醉管理[J].上海医学,2012,35(10):897-899. 被引量:9
  • 3Armonda RA,Vo AH,Dunford J,et aL Anesthesia for endovascular neurosurgery[J]. Neurosurgery,2006,59(5 Suppl 3):$66--$76,$3--S13.
  • 4Venkatraghavan L, Manninen P, Mak P, et al. Anesthesia for func- tional neurosurgery: review of complications[J]. J Neurosurg Anes- thesiol, 2006,18(1) : 64-67.
  • 5吕丹,皋源,杭燕南.右美托咪定镇静对老年患者血流动力学的影响[J].临床麻醉学杂志,2011,27(5):427-429. 被引量:30
  • 6Manne GR,Upadhyay MR,Swadia V. Effects of low dose dexmedetomidine infusion on haemodynamie stress response, se- dation and post-operative analgesia requirement in patients under- going laparoscopic cholecystectomy [J]. Indian J Anaesth,2014,58 (6) :726-731.
  • 7Tanskanen PE ,KyttaJVRandell Tr,et aL Dexmedetomidine as an anaesthetic adjuvant in patients undergoing intracranial tumour surgery:a double-blind,randomized and ebo-controlled study [J]. Br J Anaesth,2006,97(5) :658-665.
  • 8Rozet I. Anesthesia for functional neuresurgery:the role of dexmedetomidine[J]. Curr Opin Anaesthesiol,2008,21 (5) : 537-543.
  • 9杨龙慧,刁润新,高爱敏,陈亚真,王忱.右美托咪定在老年股骨颈骨折手术患者腰硬联合麻醉中的应用[J].中国实用医刊,2013,40(20):92-94. 被引量:9

二级参考文献31

  • 1佘守章,李慧玲,许学兵,莫世湟.右旋美托咪啶的镇静效应及其对全麻镇静深度的影响[J].临床麻醉学杂志,2006,22(1):10-12. 被引量:105
  • 2刘萍萍,张健,杨跃进.胸腔阻抗法测量心排血量在严重心力衰竭患者中的应用[J].中国危重病急救医学,2007,19(6):377-378. 被引量:6
  • 3Basar H, Akpinar S, Doganci N, et al. The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters. Journal of Clinical Anaesthesia, 2008,20: 431-436.
  • 4Mason KP, Zgleszewski SE, Prescilla R,et al. Hemodynamic effects of dexmedetomidine sedation for CT imaging studies. Pediatric Anaesthes, 2008,18:393- 402.
  • 5Koobi T, Kaukinen S, Ahola T, et al. Non-invasive measurement of cardiac output: whole-body impedance cardiography in simultaneous comparison with thermodilution and direct oxygen Fick methods. Intensive Care Med, 1997, 23:1132- 1137.
  • 6Kamibayashi T, Maze M. Clinical uses of a2 adrenergic agonists. Anesthesiology, 2000,93 : 1345-1349.
  • 7Pandharipane P, Ely EW, Maze M. Dexmedetomidine for sedation and perioperative management of critically ill patients. Semin Anesth Periop Med Pain, 2006,25 : 43-50.
  • 8Seals DR, Seals, Dinenno FA. Collateral damage:cardiovascular consequences of chronic sympathetic activation with human aging. Am J Physiol Heart Circ Physiol, 2004, 287: H1895-H1905.
  • 9van Oostrom H, Sfienen PJ, Doornenbal A, et al. The alpha(2)-ad- renoceptor agonist dexmedetomidine suppresses memory formation only at doses attenuating the perception of sensory input E J ]- Eur J Pharma- col, 2010,629(1/3) :58-62.
  • 10Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs mid- azolam for sedation of critically ill patients:a randomized triM[ J]. JA- MA,2009,301 ( 5 ) :489-499.

共引文献45

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部