右美托咪定对食管癌根治术患者围拔管期血流动力学的影响

Hemodynamic effect of dexmedetomidine on patients undergoing radical esophagectomy during tracheal extubation period

目的观察右美托咪定对食管癌根治术患者围拔管期血流动力学的影响。方法选择60例食管癌根治术患者，年龄65～75岁，体质量50～75kg，ASAⅡ级，随机分成右美托咪定组（D组）和对照组（C组）各30例，手术结束前30min分别给予右美托咪定0．5μg／（kg·h）和等体积的生理盐水30min，观察围拔管期（拔管前10min、拔管前5min、拔管即刻、拔管后5rain、拔管后10rain）血压、心率、血氧饱和度、苏醒时间、拔管时间、VAS评分及术后不良反应发生情况如术后烦躁、呼吸抑制、寒战。结果D组在拔管期血压、心率明显低于c组（P〈0．05），D组VAS评分〉5分和术后烦躁患者少于c组（P〈0．05），血氧饱和度、苏醒时间、拔管时间和寒战两组比较差异无统计学意义，两组患者均未出现呼吸抑制。结论右美托咪定能降低食管癌患者全身麻醉围拔管期血流动力学波动幅度。

[Abstract] Objective To observe the hemodynamic effect of dexmedetomidine on patients undergoing radical esophagectomy during tracheal extubation period. Methods Sixty patients undergoing radical esophagectomy, aged 65-75 years old, weighing 50-75 kg, ASA Ⅱ, were randomly divided into dexmedetomidine group （ group D） and control group （guoup C） with 30 patients in each group. Patients of group D were intravenously injected with 0.5 μg/ （kg. h） dexmedetomidine and the patients of group C were given normal salin 30 min before the end of the surgey. BP, HR, SpO2, waking time, extubation time, VAS-score and adverse reactions, such as dysphoria, respiratory depression, shivering were recorded at the time of before induction of anesthesia （ T1 ）, ten minites before tracheal extubation （ T2 ）, five minites before tracheal extubation （ T3 ）, the time of tracheal extubation （ T4 ）, five minites after tracheal extubation （ T5 ）, ten minites after tracheal extubation （T6）. Results BP, HR in group D were lower than those in group C （P 〈 0.05 ）. The number of severe score and dysphoria in group D were less than those in group C （P 〈 0.05 ）. There were no significant differences between the two guoups in SpO2 , waking time, tube drawing time and shivering. Respiratory depression was not found in the two groups. Conclusions Dexmedetomidine can reduce hemodynamic changes in patients undergoing radical esophagectomy during tracheal extubation period of general anethesia.