右美托咪定在老年高血压患者气管插管全身麻醉中的应用效果观察

发布时间：2018-03-27 22:11

本文选题：高血压　切入点：老年人　出处：《实用心脑肺血管病杂志》2016年01期

【摘要】：目的观察右美托咪定在老年高血压患者气管插管全身麻醉中的应用效果。方法选取2012年1月—2015年1月在北京积水潭医院行气管插管全身麻醉的老年高血压患者96例,采用随机数字表法分为观察组和对照组,各48例。观察组患者自麻醉诱导前10 min开始持续静脉泵入右美托咪定至手术完成前30 min,对照组患者自麻醉诱导前10 min开始持续静脉泵入0.9%氯化钠溶液至手术完成前30 min。比较两组患者手术时间、麻醉时间、拔管时间和苏醒时间;比较两组患者入室前、插管前1 min、插管即刻、插管后2 min、拔管前1 min和拔管后2 min血压、心率;比较两组患者插管前1 min、插管即刻、插管后2 min、拔管前1 min和拔管后2 min Ramsay镇静评分;比较两组患者不良反应发生情况。结果两组患者手术时间、麻醉时间、拔管时间和苏醒时间比较,差异无统计学意义(P0.05)。两组患者入室前和插管前1 min收缩压、舒张压、心率比较,差异无统计学意义(P0.05);观察组患者插管即刻、插管后2 min、拔管前1 min和拔管后2 min收缩压、舒张压、心率低于对照组(P0.05);观察组患者插管前1 min、插管即刻、插管后2 min、拔管前1 min和拔管后2 min Ramsay镇静评分均高于对照组(P0.05);两组患者寒战、苏醒延迟、口干、心动过缓及低血压发生率比较,差异无统计学意义(P0.05)。结论右美托咪定可减少老年高血压患者气管插管全身麻醉过程中血压、心率波动,有利于保持血流动力学稳定,镇静效果良好,且麻醉安全性较高。
[Abstract]:Objective to observe the effect of dexmetomidine on tracheal intubation general anesthesia in elderly patients with hypertension. Methods 96 elderly patients with hypertension undergoing tracheal intubation general anesthesia from January 2012 to January 2015 were selected. The method of random digital table was used to divide the two groups into observation group and control group. 48 patients in each group were continuously injected with dexmetidine from 10 min before anesthesia induction to 30 minutes before operation, while those in control group received 0.9% sodium chloride solution continuously from 10 min before anesthesia induction to the completion of operation. The operation time was compared between the two groups in the first 30 minutes. Anaesthesia time, extubation time and recovery time were compared between the two groups before intubation, 1 min before intubation, 2 min after intubation, 1 min before extubation and 2 min after extubation. The sedation scores of 1 min before extubation and 2 min after extubation were compared between the two groups. Results the time of operation, anesthesia, extubation and recovery were compared between the two groups. There was no significant difference in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) between the two groups before entering and 1 min before intubation, and there was no significant difference between the two groups (P 0.05), while in the observation group, the systolic blood pressure was 1 min before extubation and 2 min after extubation, immediately after intubation, 2 minutes after intubation, 1 min before extubation and 2 min after extubation. Diastolic blood pressure and heart rate were lower than those in control group (P 0.05), the sedative scores of Ramsay 1 min before intubation, 2 minutes after intubation, 1 min before extubation and 2 min after extubation in the observation group were higher than those in the control group. There was no significant difference in the incidence of bradycardia and hypotension (P 0.05). Conclusion dexmetomidine can reduce blood pressure and heart rate fluctuation in elderly patients with essential hypertension during general anesthesia, and is helpful to maintain hemodynamic stability. The sedation effect is good and the anesthetic safety is high.
【作者单位】：北京积水潭医院麻醉科;
【分类号】：R614

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