右美托咪定对全麻剖宫产患者血流动力学及应激反应的影响

发布时间：2018-03-24 08:43

本文选题：右美托咪定　切入点：全身麻醉　出处：《四川医科大学》2015年硕士论文

【摘要】：实验一右美托咪定对全麻剖宫产患者血流动力学及应激反应的影响目的:观察并评价全麻剖宫产患者术前泵注右美托咪定血流动力学和应激反应的变化。方法:选择需全麻的剖宫产患者40例,按照随机数字表法将其随机分为右美托咪定组(D组)和生理盐水对照组(C),每组20例,在全麻诱导前20分钟,静脉泵入生理盐水或右美托咪定0.6μg/kg/h,所有患者采用快速顺序诱导,并吸入七氟醚与氧化亚氮进行麻醉维持。观察母体心率、平均动脉压、子宫收缩、皮质醇浓度、脐带静脉血血气、新生儿Apgar评分。结果:术中母体心率、平均动脉压、皮质醇浓度D组均比C组低(P0.01),D组患者子宫收缩较C组好(P0.01),血气和Apgar评分两组无差别。结论:术前20分钟泵注右美托咪定(0.6μg/kg/h)能够安全有效的减弱全麻剖宫产患者的血流动力学波动和应激反应。实验二不同剂量右美托咪定对全麻剖宫产患者血流动力学及应激反应的影响目的:观察并评价术前泵注不同剂量右美托咪定对全麻剖宫产患者血流动力学和应激反应的变化。方法:选择需全麻的剖宫产患者60例,按照随机数字表法将其随机分为右美托咪定低剂量组(D1组)、右美托咪定中剂量组(D2组)、右美托咪定高剂量组(D3组),每组20例,在全麻诱导前20分钟,三组患者静脉分别泵入右美托咪定0.4μg/kg/h,0.6μg/kg/h,0.8μg/kg/h,所有患者采用快速顺序诱导,并静脉泵注丙泊酚进行麻醉维持。观察心率、平均动脉压、子宫收缩、皮质醇浓度、脐带静脉血血气、新生儿Apgar评分。结果:术中患者心率、平均动脉压、皮质醇浓度D2、D3组均比D1组低(P0.01),D3、D2组患者子宫收缩较D1组好(P0.01),血气和Apgar评分三组无差别。结论:静脉泵注右美托咪定0.6μg/kg/h、0.8μg/kg/h能够安全有效的减弱全麻剖宫产患者的血流动力学波动和应激反应。
[Abstract]:Effect of dextromidine on hemodynamics and stress response in patients with cesarean section under general anesthesia objective: to observe and evaluate the changes of hemodynamics and stress response in patients with general anesthesia caesarean section by pump injection of dexmetomidine before operation. Select 40 caesarean section patients who need general anesthesia. The patients were randomly divided into two groups: dexmetomidine group (group D) and saline control group (n = 20). 20 cases in each group were injected intravenously with normal saline or dexmetomidine 0.6 渭 g / kg 路kg / h 20 minutes before general anesthesia induction. All patients were induced by rapid sequential induction. The maternal heart rate, mean arterial pressure, uterine contraction, cortisol concentration, umbilical vein blood gas and neonatal Apgar score were observed. The uterine contraction in group D was lower than that in group C (P 0.01). There was no difference in blood gas and Apgar score between group D and group C. Conclusion: intravenous injection of dexmetomidine 0.6 渭 g / kg / h 20 minutes before operation can safely and effectively attenuate cesarean section under general anesthesia. Hemodynamic fluctuation and stress response. Experiment 2 effects of different doses of dexmetomidine on hemodynamics and stress response in patients with cesarean section under general anesthesia objective: to observe and evaluate the effects of different doses of dexmetomidine on general anesthesia before operation. Changes of hemodynamics and stress response in patients with cesarean section methods: 60 caesarean section patients who needed general anesthesia were selected. According to the method of random digital table, it was randomly divided into three groups: dexmetomidine low dose group, dexmetomidine middle dose group, dexmetomidine group D 2 group, dexmetomidine high dose group, D 3 group, 20 cases in each group, 20 minutes before induction of general anesthesia. All patients were induced by rapid sequential induction and administered propofol intravenously to maintain anesthesia. Heart rate, mean arterial pressure, uterine contraction, cortisol concentration and umbilical cord venous blood gas were observed. Apgar score of newborn. Results: heart rate, mean arterial pressure, The uterine contractions of D _ 2 / D _ 3 group were lower than that of D _ 1 group. There was no difference in blood gas and Apgar score among the three groups. Conclusion: intravenous infusion of dexmetomidine 0.6 渭 g / kg 路kg ~ (-1) 路h ~ (0.8 渭 g/kg/h) can safely and effectively attenuate the blood flow in patients with cesarean section under general anesthesia. Mechanical fluctuation and stress response.
【学位授予单位】：四川医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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