【摘要】：目的觀察右美托咪定對(duì)老年心血管病患者全麻下腹腔手術(shù)時(shí)麻醉蘇醒期血流動(dòng)力學(xué)指標(biāo)的影響。方法88例擇期行全麻腹腔手術(shù)的老年心血管病患者,按隨機(jī)數(shù)字表法將其分為兩組(n=44):右美托咪定組(A組)和對(duì)照組(B組),A組麻醉誘導(dǎo)后15min內(nèi)靜脈泵注右美托咪定1.0μg/kg,隨后0.6μg(kg·h)速率輸注至手術(shù)結(jié)束前30min,B組輸注等容量生理鹽水。兩組均采用全身麻醉,記錄術(shù)前、用藥前、停藥后及拔管期間血壓、心率、瑞芬太尼和異丙酚使用總量,并采靜脈血檢測(cè)術(shù)前、術(shù)后2h、4h、12h和24h的腎上腺素(Epinephrine,E)、去甲腎上腺素(Norepinephrine,NE)和內(nèi)皮素-1(Endothelin 1,ET-1)的水平。拔管后15min內(nèi)記錄患者不良反應(yīng)的情況。結(jié)果 A組拔管期血壓明顯低于B組(均P0.05);A組瑞芬太尼和異丙酚使用量明顯少于B組(均P0.05);A組嗆咳次數(shù)顯著少于B組(χ2=6.73,P0.05);A組術(shù)后2h、4h、12h和24h的E、NE和ET-1水平均顯著低于B組(t=3.02~4.74,均P0.05)。結(jié)論全麻時(shí)持續(xù)靜脈輸注右美托咪定可改善老年心血管病全麻下腹腔手術(shù)患者麻醉蘇醒期血流動(dòng)力學(xué)指標(biāo)的穩(wěn)定性。
[Abstract]:Objective to observe the effect of dexmetomidine on hemodynamics during anesthesia recovery in elderly patients with cardiovascular diseases. Methods Eighty-eight elderly patients with cardiovascular disease undergoing abdominal surgery under general anesthesia were randomly divided into two groups (n = 44): dexmetomidine group (group A) and control group (group B). After anesthesia induction, dexmetomidine was injected intravenously into 15min at a dose of 1.0 渭 g / kg, and then 0.6 渭 g (kg h) was infused at a rate of 0.6 渭 g (kg h) to the same volume of normal saline in group B 30 minutes before the end of operation. The blood pressure, heart rate, total amount of remifentanil and propofol were recorded before, after and after the extubation in both groups. Venous blood samples were collected to detect the epinephrine (Epinephrine,E) before and after 2 h, 4 h, 12 h and 24 h after operation. The levels of norepinephrine (Norepinephrine,NE) and endothelin-1 (Endothelin 1 Tet 1). Adverse reactions were recorded in 15min after extubation. Results the blood pressure of group A during extubation was significantly lower than that of group B (P0.05). The amount of remifentanil and propofol in group); A was significantly lower than that in group B (P0.05). The times of cough choking in group); A were significantly lower than those in group B (蠂 2 6.73). The levels of NE and ET-1 in group A were significantly lower than those in group B at 12 h and 24 h after operation (t = 3.02 鹵4.74, P0.05). Conclusion continuous intravenous infusion of dexmetomidine during general anesthesia can improve the stability of hemodynamics in elderly patients undergoing abdominal surgery under general anesthesia.
【作者單位】： 浙江省杭州市余杭區(qū)中醫(yī)院麻醉科;
【分類號(hào)】：R614.2

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