右美托咪定对七氟烷吸入麻醉诱导气管插管应激反应的影响

Effect of Dexmedetomidine in Terms of Stress Response of Trachea Cannula in Patients′ Induction of Anesthesia with Sevoflurane

目的探讨右美托咪定对七氟烷吸入麻醉诱导气管插管应激反应的影响。方法择期行下腹部手术患者90例,随机分为3组:空白对照组(C组)、右美托咪定低剂量组(L组)和右美托咪定高剂量组(H组)。麻醉诱导前15 min,右美托咪定两组分别静脉注射右美托咪定0.5、1.0μg/kg,完成后以0.3、0.5μg/(kg.h)泵注,对照组以同样方式静脉注射0.9%NaCl溶液,3组患者均以七氟烷行诱导麻醉,观察3组患者不同时间点心率、平均动脉压(MAP)、脑电双频谱指数(BIS)和警觉/镇静评分(OAA/S)。结果各组患者基础值(T0)比较无统计学意义;与C组比较,L组各时间点HR明显低于T0时点(P<0.05);与L组比较,H组各时点均明显下降(P<0.05),除T0时点,其他时点右美托咪定两组HR值均明显低于C组(P<0.05);H组T3、T4时点MAP值与C组差异明显(P<0.05)。T3、T4时点H、L组HR值比较差异明显(P<0.05)。与C组比较,右美托咪定两组OAA/S评分在T1、T2时点,BIS在T1、T2、T4时点比较差异明显(P<0.05)。结论右美托米定能有效减轻七氟烷吸入麻醉诱导期的应激反应,显示出剂量依耐性。

Objective To discuss the effect of Dexmedetomidine in terms of the stress response of trachea cannula in patients′ induction of Anesthesia with Sevoflurane.Methods 90 cases of patients undergoing lower abdominal surgery were randomly divided into 3 groups：control group namely group C,patients received lower doses of Dexmedetomidine namely group L,patients received high-dose of Dexmedetomidine namely group H.15 minutes before induction of anaesthesia,group L and H were given 0.5、1.0μg/kg Dexmedetomidine by intravenous injections.Afterwards,L and H group were given 0.3、0.5μg/（kg·h） Dexmedetomidine by pumping.Group C was given0.9%NaCl by intravenous injections.Those three groups of patients were induction of Anesthesia with Sevoflurane.Observations on the three groups of patients were made：Heart Rate（HR）,Mean Arterial Pressure（MAP）,Systolic Blood Pressure（SBP） and sedation scores at different time points.Results The average score of HR,MAP and SBP in three groups before operation was no statistical significance.Compared results with Group C,HR in Group L at each time point was lower than HR tested before operation（P0.05）.Compared results with Group L,HR in group H at each time point was significantly decreased（P0.05）.Except the time point before operation,HR in other time point in Group L and Group H was lower than Group C（P0.05）.MAP in Group H at T3 and T4 was no significantly difference in Group C（P0.05）.HR in Group L at T3 and T4 was different in Group H（P0.05）.The score of OAA/S in Group L and Group H at T1 and T2 was difference from Group C.The BIS in Group L and Group H at T1,T2 and T4 was difference from Group C.Conclusions Dexmedetomidine could be able to effectively reduce the stress response of induction of anesthesia with Sevoflurane,the more amount of Dexmedetomidine applied,the less amount of Sevoflurane applied.