彩色多普勒超声观察右美托咪啶对全麻诱导期股动脉血流动力学的影响

Observing the Influence of Dexmedetomidine on FemoralArtery Hemodynamics During the Induction of General Anesthesia Using Color Doppler Ultrasound

目的探讨全麻诱导前单次缓慢静脉输注右美托咪啶(Dex)对全麻诱导期股动脉彩色多普勒超声血流动力学的影响。资料与方法选择全麻下择期行腹部手术患者40例,随机分为Dex组和对照组,每组20例。麻醉诱导前Dex组静脉输注Dex(0.2μg/kg)20ml,对照组输注生理盐水20ml,输注时间10min;随后依次静脉注射舒芬太尼、丙泊酚、罗库溴铵行全麻诱导气管插管。观察并记录各时点股动脉血流收缩期峰值速度(Vs)、舒张早期反向波峰值速度(Vd)、收缩期内径(Ds)、舒张期内径(Dd)及收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率(HR)的变化。结果与基础值比较,Dex组给予Dex后10min,Vs升高、Vd降低(P<0.05);诱导后两组Vs、Vd均降低,组间比较差异无统计学意义(P>0.05);插管即刻和插管后1、3、5min,两组Vs显著降低,Dex组较对照组变化平稳(P<0.05),两组Vd上升,Dex组较对照组变化平稳(P>0.05);各时点两组Ds和Dd无明显变化(P>0.05)。与基础值比较,Dex组给予Dex后MAP、HR降低(P<0.05);诱导后两组MAP、HR降低,组间比较差异无统计学意义(P>0.05);插管即刻两组MAP、HR升高,Dex组较对照组变化平稳(P<0.05)。两组SBP、DBP、HR与Vs呈负相关(r=-0.507、-0.619、-0.750,P<0.05),两组SBP、DBP、MAP与Vd呈正相关(r=0.821、0.881、0.883,P<0.05),Vs和Vd无显著相关性(r=0.419,P>0.05)。结论全麻诱导前单次缓慢静脉输注Dex0.2μg/kg可以使股动脉Vs增快、Vd减慢,并使全麻诱导期股动脉血流动力学更平稳。

To investigate the influence of single slow intravenous infusion of dexmedetomidine （Dex） on femoral artery color Doppler hemodynamics during the induction of general anesthesia. Materials and Methods Forty patients of elective abdominal surgery under general anesthesia were elected and randomly divided into Dex group and the control group, with 20 cases ill each group. Dex （0.2 pμg/kg） 20 ml was injected with intravenous infusion in Dex group, and 20 ml saline was infused in control group, the infusion time was 10 min; then intravenous injection of Sufentanil, Propolbl and Rocuronium were performed in turn for the induction of general anesthesia and endotracheal intubation. Femoral artery peak systolic velocity （Vs）, early diastolic reverse peak velocity （Vd）, systolic diameter （Ds）, diastolic diameter （Dd）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mean arterial pressure （MAP） and heart rate （HR） changes at each time point were observed and recorded. Results ~1 Compared with baseline, Vs increased and Vd decreased （P〈0.05） 10 rain after the infusion of Dex in Dex group; after induction, Vs and Vd in both of the two groups decreased, and the difference between the two groups was not statistically significant （P〉0.05）; Vs reduced significantly in both of the two groups at the intubation moment and 1, 3, 5 rain after intubation, but the Dex group changed more smoothly （P〈0.05）, and Vd raised in both groups with the Dex group changing more smoothly （P〉0.05）; Ds and Dd of both groups did not change significantly at each time point （,~〉0.05）. ~） Compared with baseline, MAP and HR decreased （/：＇〈0.05） alter the infusion of Dex in Dex group; after induction. MAP and HR of both groups decreased, and the difference between the two groups was not statistically significant （P〉0.05）; MAP and HR increased in both groups at intubation moment, but the Dex group changed more smoothly than the control group （P〈0.05）. 6） SBP, DBP and HR were negatively correlated with Vs （p= -0.507, -0.619, - 0.750, P〈0.05） in both groups; SBP, DBP and HR were positively correlated with Vd （J=0.821, 0.881, 0.883, P〈0.05） in both groups; there was no significant correlation （r=0.419,/〉〉0.05） between Vs and Vd. Conclusion Single slow intravenous infusion of Dex （0.2 μg/kg） can accelerate the femoral artery Vs and slow down the Vd, resulting in more stable hemodynamics during the induction of general anesthesia.