右美托咪定对重症肌无力患者围术期血流动力学及苏醒质量的影响

发布时间：2018-03-24 06:07

本文选题：右美托咪定　切入点：重症肌无力　出处：《临床麻醉学杂志》2015年06期

【摘要】：目的探讨全麻术中静脉泵注右美托咪定对重症肌无力患者围术期血流动力学及苏醒质量的影响。方法选择60例择期行胸腺扩大切除术的重症肌无力患者(Ossermann I~IIb型)随机均分为右美托咪定组(D组)和对照组(C组)。D组患者麻醉诱导前,给予右美托咪定负荷剂量0.5μg/kg,然后静脉泵注0.5μg·kg-1·h-1至手术结束前30min,C组在同一时段静脉泵注同等容量的生理盐水。记录麻醉前(T1)、插管时(T2)、切皮时(T3)、劈胸骨时(T4)及拔管时(T5)的MAP、HR、单位时间内全麻药的用量;记录自主呼吸恢复时间、呼之睁眼时间和意识完全清醒时间及Steward苏醒评分。结果与T1时比较,T2~T5时两组MAP明显升高,HR明显增快(P0.05);C组全麻药用量明显高于D组(P0.05);C组自主呼吸恢复时间、呼之睁眼时间、完全清醒时间和拔管时间明显长于D组,Steward苏醒评分明显低于D组(P0.05)。结论全麻术中静脉泵注右美托咪定能够保证重症肌无力患者围术期血流动力学稳定、减少全麻药用量、缩短拔管时间,改善了患者的苏醒质量。
[Abstract]:Objective to investigate the effect of intravenous injection of dexmetomidine during general anesthesia on hemodynamics and recovery quality in patients with myasthenia gravis during perioperative period. Methods 60 patients with myasthenia gravis undergoing selective thymectomy were selected and treated with Ossermann I~IIb type. They were randomly divided into dexmetomidine group (group D) and control group (group C) before anesthesia induction. The loading dose of dexmetidine was 0.5 渭 g / kg, and then intravenous infusion of 0.5 渭 g kg-1 h-1 was given to the same volume of normal saline 30 minutes before the end of operation. Before anesthesia, T1, T2, T3, T4 and T5 were recorded before anesthesia, during intubation, during incision of sternum, and during extubation. The amount of general anesthetics per unit time; The time of spontaneous respiratory recovery was recorded. Results compared with T1, the MAP of the two groups increased significantly, the HR was significantly increased. The dosage of general anesthesia in group C was significantly higher than that in group D (P 0.05), and the time of spontaneous respiration and eye opening in group C was significantly higher than that in group C (P 0.05), and the recovery time of spontaneous respiration in group C was significantly higher than that in group C (P 0.05), and the recovery time of spontaneous respiration in group C was significantly higher than that in group C (P 0.05). The total waking time and extubation time were significantly longer than those in group D (P 0.05). Conclusion intravenous infusion of dexmetomidine during general anesthesia can ensure hemodynamic stability in patients with myasthenia gravis during perioperative period and reduce the dosage of general anesthesia. The time of extubation was shortened and the recovery quality of patients was improved.
【作者单位】：解放军第309医院麻醉科;
【分类号】：R614

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