摘要
目的观察右美托咪啶对颈丛麻醉下甲状腺手术应激反应的影响。方法美国麻醉医师学会（ASA）分级Ⅰ～Ⅱ级择期在颈丛麻醉下行甲状腺手术的患者60例，随机分为对照组（Con组）和盐酸右美托咪啶组（Dex组），每组30例，两组分别于麻醉诱导前（T0）、拔管即刻（T1）、术后第1天清晨（T2）和术后第2天清晨（T3）抽取静脉血，测定血糖、去甲肾上腺素、肾上腺素水平。结果与同组T0时间点相比，Con组T。时间点的平均动脉压（MAP）和心率（HR）均显著升高（P值均〈O．05），而Dex组在各时间点均无明显变化（P值均〉0．05）。Dex组T1时间点的MAP和HR均显著低于Con组同时间点（P值均〈0．05）。Con组T1、T2、T3时间点的血糖、去甲肾上腺素及肾上腺素水平均显著高于同组T0时间点及Dex组同时间点（P值均〈O．05）。结论颈丛麻醉期间持续应用盐酸右美托咪啶有利于维持术中血流动力学平稳，有效降低行甲状腺手术患者的围术期血糖、去甲肾上腺素、肾上腺素水平，抑制围术期席激反席。
Objective To investigate the effects of dexmedetomidine on stress response of patients undergoing thyroid surgery under cervical plexus block anesthesia. Methods Sixty patients （American Society of Anesthesiologists [ASA] graded Ⅰ - Ⅱ ） scheduled for elective thyroid surgery under cervical plexus block anesthesia were randomly assigned to dexmedetomidine （Dex） group and control （Con） group （n = 30 in each）. Blood samples were taken immediately before anesthetic induction （To）, after tracheal extubation （T1）, day 1 and day 2 postoperatively （T2, T3 ） for determining the plasma levels of glucose, noradrenaline and adrenaline. Results Mean artery pressure （MAP） and heart rate （HR） at T1 were significantly elevated （P 〈 0. 05） compared to those of To in control group, while there was no significant change at all the time points in Dex group （P〈0.05）. MAP and HR at T1 were significantly lower in Dex group than those in control group （P〈0.05）. The plasma glucose, noradrenaline and adrenaline at T1 - T3 were significantly increased compared to those at To in control group （P 〈 0. 05）. furthermore, there were significantly differences between the two groups at corresponding time points （P 〈 0. 05）. Conclusion Continuous dexmedetomidine infusion can decrease perioperative blood glucose, plasma noradrenaline and adrenaline in patients receiving thyroid surgery, subsequently, inhibiting their perioperative stress response. （Shanghai Med J, 2011, 34： 747-749）
出处
《上海医学》
CAS
CSCD
北大核心
2011年第10期747-749,共3页
Shanghai Medical Journal
