右美托咪定对后腹腔镜术中应激反应的影响

发布时间：2018-05-06 17:09

  本文选题：右美托咪定 + 后腹腔镜手术　； 参考：《临床麻醉学杂志》2015年06期

【摘要】：目的探讨右美托咪定在后腹腔镜术中对应激反应的影响。方法择期行后腹腔镜下肾癌根治术的患者60例,男48例,女12例,年龄35~75岁,体重50~81kg,分为右美托咪定组(D组)和对照组(C组),每组30例。全身麻醉诱导前,D组10min内静脉泵入右美托咪定1μg/kg,续以0.5μg·kg-1·h-1泵入,手术结束前30min停药。C组给予等量0.9%氯化钠注射液。所有患者采用静脉注射咪达唑仑0.02~0.04mg/kg、丙泊酚1.0~2.0mg/kg、顺式阿曲库铵0.2mg/kg及舒芬太尼0.5μg/kg进行麻醉诱导。两组患者术中连续监测BP、HR、ECG、SpO2,记录开始诱导泵入右美托咪定前(T0)、气管插管即刻(T1)、开始气腹时(T2)、拔出气管导管后即刻(T3)和拔管5min后(T4)的MAP和HR,并于各时点抽取非静脉输液侧肘静脉血,放免法测定血浆皮质醇(Cor)和血管紧张素-Ⅱ(A-Ⅱ)的水平。结果与C组比较,T0~T3时D组MAP明显降低,HR明显减慢(P0.05);与C组比较,T1~T3时D组的Cor浓度明显降低(P0.05),T4时D组的A-Ⅱ浓度明显降低(P0.05)。结论全麻中加入右美托咪定可以抑制围术期应激反应。
[Abstract]:Objective to investigate the effect of dexmetidine on stress response during retroperitoneal laparoscopy. Methods A total of 60 patients (48 males and 12 females) who underwent retroperitoneal laparoscopic radical nephrectomy were divided into group D (group D) and control group (group C (n = 30), aged 35 ~ 75 years, weight 50 ~ 81kg). Before general anesthesia induction, dexmetomidine 1 渭 g / kg was injected intravenously into 10min in group D, followed by 0.5 渭 g kg-1 h-1. Before the end of operation, 0.9% sodium chloride was given to group C. All patients were induced by intravenous midazolam 0.02 mg / kg, propofol 1.0 mg / kg, cis atracurium 0.2mg/kg and sufentanil 0.5 渭 g/kg. Two groups of patients were monitored continuously during operation. The MAP and HRS of BPHRN ECG SpO2 were recorded. The MAP and HRS of BPHRN ECG SpO2 were recorded, and the non-venous infusion of elbow blood was taken at each time point. T1, T2, T3) and T4 after extubation were recorded immediately after endotracheal intubation and tracheal intubation, respectively. Plasma cortisol Corr and angiotensin 鈪，

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