| 右美托咪定不同给药方式对颅内动脉瘤伴高血压患者全身麻醉诱导期血流动力学的影晌 |
| 投稿时间：2017-02-21 修订日期：2017-03-25 点此下载全文 |
| 引用本文：李娟,陈宇,杨璐,李军,曹福羊.右美托咪定不同给药方式对颅内动脉瘤伴高血压患者全身麻醉诱导期血流动力学的影晌[J].医学研究杂志,2017,46(12):104-107 |
| DOI：
10.11969/j.issn.1673-548X.2017.12.026 |
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| 中文摘要:目的 探讨右美托咪定不同给药方式对颅内动脉瘤伴高血压患者全身麻醉诱导期血流动力学的影晌。方法 选取于2014年3月~2016年10月在笔者医院收治拟行手术治疗的颅内动脉瘤患者72例，按数学表法随机分为右美托咪定静脉泵注组（DC组，n=24）、右美托咪定单次静脉注射组（DS组，n=24）和对照组（C组，n=24）。在进行麻醉诱导前，DC组以0.3μg/（kg·h）速度持续泵注右美托咪定至手术结束前30min；DS组采用微量泵持续静脉注射右美托咪定，总量为1μg/kg溶于20ml生理盐水中，静脉泵注时间为10min；C组采用微量泵静脉注射与DS组等量生理盐水，泵注时间为10min，3组其余用药相同。记录比较3组患者入手术室平静休息3min时（T0）、气管内插管前即刻（T1）、气管内插管完成即刻（T2）、插管后3min （T3）的SBP、DBP、MAP和HR以及△SBP、△DBP、△MAP和△HR；并记录麻醉诱导期间硝酸甘油、麻黄素和阿托品使用情况。结果 3组患者基线资料比较，差异均无统计学意义（P>0.05）。DS组和DC组△SBP、△DBP、△MAP、△HR均低于C组（P<0.05）。结论 麻醉诱导期使用1μg/kg右美托咪定单次静脉注射，即可有效抑制插管反应所导致的交感神经兴奋，并可使患者血流动力学维持在稳定状态，特别适用于颅内动脉瘤合并高血压患者的麻醉诱导。 |
| 中文关键词:右美托咪定 颅内动脉瘤 不同给药方式 麻醉诱导期 血流动力学波动 |
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| Effects of Different Infusion Methods of Dexmedetomidine on Hemodynamic Responses in Cerebral Aneurysm Patients with Hypertensive during Anesthesia Induction |
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| Abstract:Objective To explore the effects of dexmedetomidine different infusion Methods on hemodynamic responses in cerebral aneurysm patients with hypertensive during anesthesia induction.Methods Totally 72 cases of patients were selected in our hospital who diagnosed with intracranial aneurysms and be treated by surgical from Mar 2014 to Oct 2014, according to random number table were randomly divided into the right mi fixed vein pump injection group (DC group, n=24), the right beauty mi order time intravenous injection group (DS group, n=24) and the control group (group C, n=24). Before anesthesia induction, DC group patients received 0.3μg/(kg·h) dexmedetomidine continues puming until 20min before the end of the operation. DS group patients were admillistered intravenous at a total of 1μg/(kg·10min)which dissolved in 20 ml saline; group C patients were admillistered intravenous the same amount of saline as DS group. Pump injection time was 10min, and other anesthetics were equalized. Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure and heart rate(HR)were monitored and recorded at 3 minutes after lying on table(T0),before intubation(T1),immediately and 3min utes after intubation(T2,T3).The differences between the maximum and the minimum of SBP,DBP, MAP and HR were calculated in these time points as fluctuation values,named as △SBP,△DBP,△MAP and △HR. Nitroglycerin, ephedrine and atropine usage were recorded during anesthesia induction.Results These was no statistically significant difference in baseline data among the three groups patients.△SBP,△DBP,△MAP and △HR in group DS(12.2±5.8mmHg,14.2±7.4mmHg,25.4±9.2mmHg,12.6±6.8times/min) were lower than those in group C(42.4±13.6mmHg,26.5±8.3mmHg,30.6±11.2mmHg,30.2±10.3times/min,P<0.05). As well as △SBP,△DBP,△MAP and △HR in group DC(32.2±10.7mmHg,16.6±7.4mmHg,21.8±8.6mmHg,12.6±6.8times/min) were lower than those in group C(P<0.05).Conclusion Dexmedetomidine 1μg/kg injected before anesthesia induction,which could prevent intubation reaction, and provide more stable hemodynamics,is particularly applicable for anesthesia induction in patients with cerebral aneurysm and hypertension. |
| keywords:Dexmedetomidine Cerebral aneurysm Different infusion methods Anesthesia induction Hemodynamic fluctuations |
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