右美托咪定用于减轻颅内动脉瘤患者麻醉诱导期血流动力学波动的临床价值

发布时间：2018-04-28 16:18

本文选题：右美托咪定 + 颅内动脉瘤　；参考：《重庆医学》2015年04期

【摘要】：目的探讨右美托咪定在颅内动脉瘤患者手术麻醉诱导期减少血流动力学波动的临床应用价值。方法选取该院2012年6月至2013年6月收治的颅内动脉瘤患者80例,使用随机数字表法将患者分为芬太尼组和复合组,每组40例。在进行麻醉诱导前,对芬太尼组注射0.9%氯化钠;复合组经微量泵进行右美托咪定的静脉注射,总量为1μg/kg,泵注时间为10min。在进行麻醉诱导时,芬太尼组和复合组经静脉注射3μg/kg芬太尼,两组其余用药相同。对患者入手术室平静休息3min(T1)、气管内插管前(T2)、插管后即刻(T3)、插管后3min(T4)的舒张压、收缩压、心率进行详细记录,将患者麻醉诱导期间的舒张压、收缩压和心率最大值和最小值的差定义为波动值。结果芬太尼组患者在T2时收缩压比T1时明显降低(P0.05),T3、T4时收缩压、心率以及T3时舒张压较T1时明显升高(P0.05)。复合组在T2时收缩压和心率及T4时收缩压、舒张压与T1时相比明显降低(P0.05)。复合组患者收缩压、舒张压和心率的波动值均显著低于芬太尼组(P0.05)。结论右美托咪定在颅内动脉瘤患者麻醉诱导期的使用即抑制了插管操作造成的交感神经兴奋,还使患者血流动力学维持在稳定状态,对颅内动脉瘤患者手术的顺利完成具有重要意义,值得临床推广使用。
[Abstract]:Objective to evaluate the clinical value of dexmetomidine in reducing hemodynamic fluctuation during anesthesia induction in patients with intracranial aneurysms. Methods from June 2012 to June 2013, 80 patients with intracranial aneurysms were randomly divided into fentanyl group and compound group with 40 cases in each group. Before anesthesia induction, 0.9% sodium chloride was injected into fentanyl group, and dexmetomidine was injected intravenously by micropump in compound group, the total dose was 1 渭 g / kg, and the injection time was 10 min. During anesthesia induction, fentanyl group and compound group were intravenously injected with 3 渭 g/kg fentanyl. Diastolic blood pressure (DBP), systolic pressure (SBP), heart rate (HR) were recorded at 3 min after intubation, before endotracheal intubation, immediately after intubation, and 3 min after intubation. The diastolic blood pressure during anesthesia induction was recorded in detail. The difference between systolic blood pressure and heart rate maximum and minimum is defined as fluctuation. Results in fentanyl group, systolic blood pressure at T 2 was significantly lower than that at T 1. Heart rate and diastolic blood pressure at T 3 were significantly higher than those at T 1. Systolic blood pressure (SBP) and heart rate (HR) and systolic blood pressure (SBP) and diastolic blood pressure (DBP) at T 2 and T 4 in the composite group were significantly lower than those at T 1 and T 1, respectively. Systolic blood pressure, diastolic blood pressure and heart rate in compound group were significantly lower than those in fentanyl group (P 0.05). Conclusion the use of dexmetidine in the induction period of anesthesia in patients with intracranial aneurysms not only inhibits the sympathetic excitement caused by intubation, but also keeps the hemodynamics in a stable state. It is of great significance for the successful operation of intracranial aneurysms and is worth popularizing in clinic.
【作者单位】：河北医科大学第一医院麻醉科;
【基金】：河北省科技计划项目(112761126)
【分类号】：R614

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