右美托咪定对全麻患儿压力反射功能的影响

发布时间：2018-12-12 12:07

【摘要】：目的观察右美托咪定(Dex)对小儿全身麻醉后动脉压力感受性反射功能的影响。方法选择60例择期全麻下行隐匿性阴茎矫治术的患儿,随机分为2组(n=30)。Dex组入室后静脉泵注Dex 0.5μg/kg,10 min后改为0.4μg/(kg·h)维持至术毕;对照组,泵注等容量的生理盐水,其余麻醉用药相同。选择入室平静后(T1)、Dex或生理盐水负荷量泵注后即刻(T2)、置入喉罩后5 min(T3)、手术开始后5 min(T4)、术毕清醒(T5)5个时点,采集测量压力感受性反射敏感性(BRS)值和血流动力学指标(MAP和HR)。结果与T1时点相比,对照组T2时点BRS值差异无统计学意义,T3~T5时点的BRS值均降低(P0.05);Dex组T2时点BRS值显著升高(P0.05),T3时点BRS值降低(P0.05),而T4、T5时点差异无统计学意义。与对照组相比,Dex组在T2~T5各时点BRS值均较高,差异有统计学意义(P0.05)。与T1相比,两组患儿的MAP在T2时点差异无统计学意义,T3、T4时间点均降低(P0.05),T5时点差异无统计学意义;在T2~T5时点两组之间差异无统计学意义。与T1相比,对照组T2时点HR差异无统计学意义,T3,T4时点HR减慢(P0.05),T5时点HR加快(P0.05);Dex组T2~T4时点HR均减慢(P0.05),T5时点HR加快(P0.05);与对照组相比,Dex组T2~T5时点HR均降低(P0.05)。结论全麻药物降低小儿动脉压力感受性反射功能,Dex可改善全麻药物对小儿BRS的抑制作用,有利于维持血流动力学稳定。
[Abstract]:Objective to observe the effect of dexmetomidine (Dex) on arterial baroreflex after general anesthesia in children. Methods Sixty children with occult penile correction under elective general anesthesia were randomly divided into 2 groups (n = 30). Dex). The patients were treated with Dex 0.5 渭 g / kg for 10 min and maintained at 0.4 渭 g / (kg h) until the end of operation. In the control group, the same volume of saline was injected by pump, and the other anesthetic drugs were the same. 5 min (T 3), 5 min (T 4), 5 min (T 5) after operation, 5 min after operation (T 5), 5 min (T 4), 5 min (T 5) after operation. (BRS) values of baroreflex sensitivity and hemodynamic indices (MAP and HR).) were collected and measured. Results compared with T1, there was no significant difference in BRS value at T2 time point in control group, but BRS value at T3~T5 time point decreased (P0.05). In Dex group, BRS increased significantly at T2 (P0.05), BRS decreased at T3 (P0.05), but there was no significant difference at T4T5. Compared with the control group, the BRS value of Dex group was higher at each time point of T2~T5, the difference was statistically significant (P0.05). Compared with T1, there was no significant difference in MAP between the two groups at T2 time point, while T3 / T4 time point decreased (P0.05), T5 time point difference was not statistically significant, and there was no significant difference between the two groups at T2~T5 time point. Compared with T1, there was no significant difference in HR at T2 in control group. HR decreased at T3 / T4 (P0.05), HR increased at T5 (P0.05), HR decreased at T2~T4 (P0.05) in T5 (P0.05), HR increased at T5 (P0.05). Compared with the control group, T2~T5 HR in Dex group was significantly lower than that in control group (P0.05). Conclusion General anesthesia can reduce arterial baroreflex in children. Dex can improve the inhibitory effect of general anesthesia on pediatric BRS and maintain hemodynamic stability.
【作者单位】：安徽医科大学附属省儿童医院(安徽省儿童医院)麻醉科;安徽医科大学第一附属医院麻醉科;
【基金】：2013年高等学校博士学科点专项科研基金(编号:20133420110009)
【分类号】：R726.1

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