右美托咪定对老年心血管病患者全麻下腹腔手术时麻醉苏醒期血流动力学指标的影响

发布时间：2018-12-21 14:33

【摘要】：目的观察右美托咪定对老年心血管病患者全麻下腹腔手术时麻醉苏醒期血流动力学指标的影响。方法88例择期行全麻腹腔手术的老年心血管病患者,按随机数字表法将其分为两组(n=44):右美托咪定组(A组)和对照组(B组),A组麻醉诱导后15min内静脉泵注右美托咪定1.0μg/kg,随后0.6μg(kg·h)速率输注至手术结束前30min,B组输注等容量生理盐水。两组均采用全身麻醉,记录术前、用药前、停药后及拔管期间血压、心率、瑞芬太尼和异丙酚使用总量,并采静脉血检测术前、术后2h、4h、12h和24h的肾上腺素(Epinephrine,E)、去甲肾上腺素(Norepinephrine,NE)和内皮素-1(Endothelin 1,ET-1)的水平。拔管后15min内记录患者不良反应的情况。结果 A组拔管期血压明显低于B组(均P0.05);A组瑞芬太尼和异丙酚使用量明显少于B组(均P0.05);A组呛咳次数显著少于B组(χ2=6.73,P0.05);A组术后2h、4h、12h和24h的E、NE和ET-1水平均显著低于B组(t=3.02~4.74,均P0.05)。结论全麻时持续静脉输注右美托咪定可改善老年心血管病全麻下腹腔手术患者麻醉苏醒期血流动力学指标的稳定性。
[Abstract]:Objective to observe the effect of dexmetomidine on hemodynamics during anesthesia recovery in elderly patients with cardiovascular diseases. Methods Eighty-eight elderly patients with cardiovascular disease undergoing abdominal surgery under general anesthesia were randomly divided into two groups (n = 44): dexmetomidine group (group A) and control group (group B). After anesthesia induction, dexmetomidine was injected intravenously into 15min at a dose of 1.0 渭 g / kg, and then 0.6 渭 g (kg h) was infused at a rate of 0.6 渭 g (kg h) to the same volume of normal saline in group B 30 minutes before the end of operation. The blood pressure, heart rate, total amount of remifentanil and propofol were recorded before, after and after the extubation in both groups. Venous blood samples were collected to detect the epinephrine (Epinephrine,E) before and after 2 h, 4 h, 12 h and 24 h after operation. The levels of norepinephrine (Norepinephrine,NE) and endothelin-1 (Endothelin 1 Tet 1). Adverse reactions were recorded in 15min after extubation. Results the blood pressure of group A during extubation was significantly lower than that of group B (P0.05). The amount of remifentanil and propofol in group); A was significantly lower than that in group B (P0.05). The times of cough choking in group); A were significantly lower than those in group B (蠂 2 6.73). The levels of NE and ET-1 in group A were significantly lower than those in group B at 12 h and 24 h after operation (t = 3.02 卤4.74, P0.05). Conclusion continuous intravenous infusion of dexmetomidine during general anesthesia can improve the stability of hemodynamics in elderly patients undergoing abdominal surgery under general anesthesia.
【作者单位】：浙江省杭州市余杭区中医院麻醉科;
【分类号】：R614.2

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