右旋美托咪定对全麻高血压患者拔管期的影响

Effect of Dexmedetomidine on Clinical Profiles in Patients with Hypertension in the Period of Tracheal Extubation

目的:观察手术结束前给予右旋美托咪定对全麻高血压患者围拔管期的影响。方法:40例ASAⅠ-Ⅲ级择期行盆腹腔手术高血压患者,随机分为右旋美托咪定组(D组)和生理盐水组(C组)。两组患者全麻诱导和维持相同,术毕前30分钟D组患者10分钟内静脉泵注1ug/kg的右旋美托咪啶,C组患者以相同速率静脉泵注相同容量生理盐水。观察并记录收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(SpO2)、苏醒时间(t1)、拔管时间(t2)以及相关不良反应。结果:拔管前至拔管后10分钟D组患者的SBP、DBP、HR均明显低于C组(p<0.05)。D组患者的耐管评分明显优于C组(p<0.05)。结论:右旋美托咪定能有效降低高血压患者全麻围拔管期的心血管反应,增强患者的气管导管耐受性。

Objective：To determine the effect of administration of dexmedetomidine by the end of operation on clinical profiles in the period of extubation in general anesthesia patients with hypertension.Methods： 40 patients with hypertension who were undergoing lower abdominal or pelvic surgery were randomly divided into control group（group C） or dexmedetomidine group（group D）.The scheme of induction and maintenance of anesthesia of the two groups were identical.Patients in group D were administered dexmedetomidine at a dose of 1ug/kg over 10 min and in group C patients were given a placebo infusion of normal saline at identical rates at 30 min by the end of the operation.Systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）,pulse oxygen saturation（SpO2）,the recovery time（open eye,t1）,extubation time（t2） and adverse effects were recorded.Results：SBP、DBP、HR in group D during peri-extubation were significantly different from those in group C which fluctuated more markedly（p0.05）.Tolerance score to endotracheal tube in group D was superior to that in group C（p0.05）.Conclusion： Dexmedetomidine could effectively reduce the cardiovascular response to extubation in patients with hypertention and strengthen the patients＇ tolerance to endotracheal tube.