右美托咪定经鼻腔给药对妇科全麻围拔管期应激反应的影响

发布时间：2018-08-13 18:37

【摘要】：目的观察不同剂量右美托咪定经鼻腔给药对妇科全麻围拔管期应激反应的影响,并探讨最佳剂量。方法择期妇科手术患者80例,随机分为对照组(C组)和不同剂量右美托咪定滴鼻组(D1组、D2组、D3组)。手术结束前30 min,D1、D2、D3组分别经鼻滴注右美托咪定0.6、1.2、1.8μg/kg,C组用生理盐水滴鼻。记录给药前即刻(T_1)、手术结束时(T_2)、患者可唤醒时(T_3)、拔管时(T_4)、拔管后1min(T_5)、5min(T_6)、10min(T_7)的HR、MAP、SBP与HR乘积(RPP);检测T_1、T_2、T_4、T_6时血浆去甲肾上腺素(NE)和皮质醇(Cor)浓度。记录患者术后恢复指标。结果与C组比较,T_3~T_5时D1组、T_2~T_7时D2、D3组MAP和RPP均明显降低,HR明显减慢(P0.05);T_4、T_6时D1组、T_2、T_4和T6时D2、D3组血浆NE、Cor浓度明显降低(P0.05)。C组、D1组和D2组唤醒时间、拔管时间及PACU留观时间均明显短于D3组(P0.05)。结论手术结束前30min给予右美托咪定1.2μg/kg滴鼻可有效抑制全麻手术拔管期的应激反应,同时不影响术后恢复。
[Abstract]:Objective to observe the effects of different doses of dexmetidine through nasal cavity on stress response during extubation of gynecological general anesthesia. Methods Eighty patients undergoing gynecological surgery were randomly divided into two groups: control group (group C) and group D _ 1 with different doses of dexmemetidine (D _ 1 group) and D _ 2 group (D _ 3 group). 30 minutes before the end of the operation, right metoimidine was given to D 1, D 2, D 2 and D 3 groups 30 minutes before the end of the operation, respectively. The right metoimidine was administered to the control group with normal saline at the dose of 1. 8 渭 g 路kg ~ (-1) 路kg ~ (-1). The levels of plasma norepinephrine (NE) and cortisol (Cor) (Cor) in plasma were measured in T _ 1T _ 2, T _ 3, T _ 4, T _ 4, 1min (T _ 5) 5 min (T _ 6) ~ 10 min (T _ 7) and HRMAPSBP and HR product (RPP); in T _ (1) T _ (2) T _ (2) T _ (4) T _ (6) and T _ (1) T _ (2) T _ (2) T _ (6) T _ (6), T _ (1) T _ (2) T _ 2T _ (4) T _ (6) and T _ (1) T _ (2) T _ (2) T _ (6) T _ (6). The index of postoperative recovery was recorded. Results compared with group C, the MAP and RPP of D1 group were significantly lower than that of C group (P0.05). The plasma NECor concentration of D2D3 group was significantly lower than that of D2D3 group (P0.05). The time of extubation and PACU stay in D2D3 group was significantly shorter than that in D3 group (P0.05). Conclusion 30min administration of dexmetomidine 1.2 渭 g/kg before operation can effectively inhibit the stress response during extubation of general anesthesia without affecting postoperative recovery.
【作者单位】：南京医科大学附属南京医院(南京市第一医院)麻醉科;
【分类号】：R614

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