颅内动脉瘤伴高血压患者围术期应用右美托咪定临床效果观察

Perioperative Administration of Dexmedetomdine in Intracranial Aneurysm Patients with Hypertension

目的:评价右美托咪定用于颅内动脉瘤伴高血压患者围术期临床效果。方法:34例拟行动脉瘤夹闭术的颅内动脉瘤伴高血压患者,随机分为右美托咪定组(A组)和对照组(B组),记录并比较两组患者入室后10min(给药前)、麻醉诱导前10min及手术切皮时的平均动脉压(MAP)和心率(HR),以及控制降压使血压稳定在基础血压的70%时硝酸甘油的剂量。结果:给药后A组MAP和HR降低,明显低于B组(P<0.05);手术开始时A组MAP及HR低于B组(P<0.05);控制性降压维持血压为基础血压的70%,右美托咪定组硝酸甘油剂量较对照组低约25%(P<0.05)。结论:对动脉瘤伴高血压患者围麻醉期应用右美托咪定可以镇静、镇痛、降低心率血压,稳定血流动力学,降低动脉瘤破裂风险,减少血管活性药用量,并具有脑保护作用。

Objective： To investigate the effect of dexmedetomidine as a perioporation drug in intracranial aneurysm patients with hypertension.Methods： Thirty-four patients with intracranial aneurysm with hypertension for surgery were randomly and equally divided into dexmedetomidine group（group A） and control group（group B）.Mean artery pressure（MAP） and heat rate（HR） of the patients were measured and compared at the point of 10 minutes after the patients went into the operation room,10 minutes before anesthesia,and at the beginning of the operation.The dose of nitroglycerin was recorded when the MAP reached 70% of the foundation blood pressure during controlling the hypotension.Results： The MAP and HR of the patients of group A reduced（P〈0.05,versus group B） after receiving dexmedetomidion and at the beginning of the operation.The dose of nitroglycerin of group A was about 25% lower than of group B to control the pressure（P〈0.05）.Conclusion： Dexmedetomidion used as a peri-anaesthetic drug for intracranial aneurysm patients with hypertension has the functions of sedation,analgesia,reducing the heart rate and blood pressure,and stabilizing hemodynamics,thus it can reduce the risk of aneurysm rupture,reduce the dose of nitroglycerin,and protect the cerebral function.