右美托咪定对心脏瓣膜置换术患者麻醉中血流动力学的影响
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篇名: 右美托咪定对心脏瓣膜置换术患者麻醉中血流动力学的影响
TITLE:
摘要:

目的:探讨右美托咪定对心脏瓣膜置换术患者麻醉中血流动力学的影响。方法:92 例心脏瓣膜置换术患者按随机数字

表法分为观察组和对照组,各46 例。两组患者均采用咪达唑仑1~2 mg/kg+芬太尼0.05 mg/kg+丙泊酚1~2 mg/kg+顺式阿曲库铵

0.15 mg/kg 常规麻醉诱导方案。观察组患者在常规麻醉诱导方案基础上加用右美托咪定0.5 μg/kg,10 min 内静脉泵入,然后以

0.4 μg/(kg·h)维持麻醉至手术结束;对照组患者在常规麻醉诱导方案基础上给予等量生理盐水静脉泵入。记录两组患者麻醉诱

导前(T0)、给药后5 min(T1)、麻醉诱导后2 min(T2)、气管插管成功后1 min(T3)、气管插管成功后3 min(T4)、气管插管成功后5 min

(T5)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、心输出量(CO)、心指数(CI)、每搏量(SV)、每搏变异度

(SVV)水平及T0、T1时镇静评分(OAA/S评分),观察两组患者麻醉过程中的不良反应。结果:两组患者T0~T5时SVV水平比较,

差异无统计学意义(P>0.05);观察组患者T0~T5时SBP 、DBP、MAP、HR、CO、CI、SV水平均优于对照组,两组比较差异均有统计

学意义(P<0.01);两组患者T0时OAA/S评分比较,差异无统计学意义(P>0.05),T1时观察组患者OAA/S评分显著降低且低于对

照组,差异有统计学意义(P<0.01)。两组患者心动过缓、低血压等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:

右美托咪定用于心脏瓣膜置换术麻醉能有效降低对患者麻醉诱导期血流动力学的影响,且安全性较好。

ABSTRACT:

OBJECTIVE:To observe the effects of dexmedetomidine on hemodynamics of patients underwent cardiac valve replacement

in the anesthesia induction. METHODS:92 patients underwent cardiac valve replacement were randomly divided into observation

group and control group,with 46 patients in each group. Both groups received routine anesthesia induction regimen of

midazolam 1-2 mg/kg+ fentanyl 0.05 mg/kg+ propofol 1-2 mg/kg+ cis-atracurium 0.15 mg/kg. Observation group was additionally

given dexmedetomidine 0.5 μg/kg,within 10 min with pumps,and then maintained with 0.4 μg/(kg·h)till the end of operation;

control group was additionally given constant volume of normal saline with pumps. SBP,DBP,MAP,HR,cardiac output(CO),

cardiac index(CI),stroke volume(SV),stroke volume variation(SVV)before anesthesia induction(T0),5 min after medication

(T1),2 min after anesthesia induction(T2),1 min after intubation(T3),3 min after intubation(T4)and 5 min after intubation

(T5)were recorded in 2 groups as well as OAA/S at T0 and 5 min after pumping dexmedetomidine(T1). ADR of 2 groups during

anesthesia was also recorded. RESULTS:There was no significantly difference in SVV of 2 groups at T0-T5 (P>0.05);SBP,

DBP,MAP,HR,CO,CI and SV of observation group at T0-T5 were all better than those of control group,with statistical significance(

P<0.01);there was no statistically significant difference in OAA/S of 2 groups at T0(P>0.05),and OAA/S of observation

group at T1 was decreased significantly and lower than control group,with statistical significance(P<0.01). There was no statistically

significant difference in the incidence of ADR as cardiac arrhythmia and hypotension between 2 groups(P>0.05). CONCLUSIONS:

Dexmedetomidine can reduce the influence of anesthesia on the hemodynamics of patients underwent cardiac valve replacement

with good safety.

期刊: 2015年第26卷第35期
作者: 詹长春,黄焕森
AUTHORS: ZHAN Chang-chun,HUANG Huan-sen
关键字: 右美托咪定;心脏瓣膜置换术;麻醉诱导;血流动力学
KEYWORDS: Dexmedetomidine;Cardiac valve replacement;Anesthesia induction;Hemodynamics
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