右美托咪定应用于高血压全麻患者围拔管期的临床研究

Clinical observation of dexmedetomidine on hypertensive patients with general anesthesia in peri-extubation period

目的探讨右美托咪定应用在高血压患者全麻手术围拔管期的临床效果。方法选取60例合并高血压行全麻开腹手术的患者,随机分为实验组(D组)和对照组(N组),两组均采取相同的全麻诱导与维持方式,在手术结束前并停用麻醉药时,D组给予右美托咪定1ug/kg、浓度4 ug/mL,缓慢泵注10 min,N组给予相同速率泵注等容量生理盐水。观察记录围拔管期患者的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、脑电双频指数(BIS)、苏醒时间(T1)、拔管时间(T2)及不良反应。结果拔管前l min、后10 min,D组患者的MAP和HR均明显低于N组,比较差异有统计学意义(P<0.05)。结论右美托咪定能有效减轻高血压全麻患者在拔管期心血管反应和气道反射,同时可降低术后躁动等不良反应。

Objective To dexmedetomidine application in extubation of clinical effect. Methods All of 60 patients hypertensive patients in anesthesia operation during tracheal with hypertension undergoing general anesthesia abdominal operation patients, were randomly divided into experimental group（group D） and control group （group N）, two groups were taken with the same general anesthesia induction and maintenance in operation before the end, and disable the anesthetics, D group with dexmedetomidine, lug/kg the concentration of 4ug/mL, slow infusion of 10rain, N group was given the same rate and volume of physiological saline infusion. Observe and record the extubation in patients with mean arterial pressure （MAP）, heart rate （HR）, oxygen saturation （SpO2）, bispectral index （BIS）, recovery time （%）, extubation time （T2） and adverse reaction. Results Before extubation after lmin, 10 min, MAP and HR in D group were significantly lower than those in N group, compared with significant difference（P 〈 0.05）, with statistical significance. Conclusion Dexmedetomidine can effectively reduce the hypertension patients with general anesthesia on cardiovascular response to tracheal extubation and airway reflexes, and simultaneously can reduce postoperative agitation and other adverse reactions.