盐酸右美托咪定对全麻患者围拔管期应激反应的影响

Effect of dexmedetomidine on stress response to extubation in patients undergoing general anesthesia

目的探讨盐酸右美托咪定对全麻患者围拔管期应激反应的抑制作用。方法全凭静脉麻醉下行上腹部手术患者42例随机均分为两组,A组拔管前输注盐酸右美托咪定0.2-0.7μg·kg^-1·h^-1,B组不用盐酸右美托咪定作为对照。记录拔管前、拔管时、拔管后10 min以及20 min的平均动脉压（MAP）、心率（HR）,并采集静脉血,测定血浆皮质醇（Cor）和血糖（BG）浓度。结果与拔管前比较,B组拔管期MAP和HR均明显升高（P〈0.05）,A组拔管时和拔管后10 min的MAP和HR均低于B组（P〈0.05）。A组拔管后10 min的Cor明显低于B组[（253.2±33.7）mg/Lvs.（278.5±45.2）mg/L],BG亦低于B组[（5.18±0.59）mmol/L vs.（5.58±0.58）mmol/L]（P〈0.05）。结论盐酸右美托咪定能有效减轻上腹部手术患者拔管期的应激反应。

Objective To investigate the inhibitory effect of dexmedetomidine on stress response to extubation in patients undergoing general anesthesia.Methods Fourty-two patients undergoing upper abdominal surgery under total intravenous anesthesia（TIVA） were randomly divided into two groups with 21 cases each.Dexmedetomidine 0.2-0.7 μg·kg^-1·h^-1 was infused during extubation in group A,which was not in group B as the control.Mean arterial pressure（MAP）,heart rate（HR） were recorded and plasma cortisol（Cor） and blood glucose（BG） were measured before,during extubation,at 10 min and 20 min after extubation.Results Compared to before extubation,MAP and HR in group B were significantly increased during extubation（P〈0.05）.During extubation and at 10 min after extubation,MAP and HR were significantly lower in group A than those in group B（P〈0.05）.At 10 min after extubation,Cor and BG were significantly lower in group A than those in group B [（253.2±33.7） mg/L vs.（278.5±45.2） mg/L and（5.18±0.59） mmol/L vs.（5.58±0.58） mmol/L]（P〈0.05）.Conclusion Dexmedetomidine is able to effectively reduce stress response to extubation in patients undergoing general anesthesia.