右美托咪啶对小儿脑瘤切除术血流动力学的影响

Effect of dexmedetomidine on hemodynamics in children undergoing brain tumor excision

目的观察右美托咪啶对小儿脑瘤切除术病儿麻醉血流动力学的影响。方法 32例脑瘤切除术的病儿随机分为右美托咪啶组(右美组)和对照组,每组16例。麻醉前10 min静泵注右美托咪啶1μg/kg,并以0.5μg/(kg.h)的速率维持给药,对照组给予等量的生理盐水。于诱导前、气管插管前、插管后3 min、切皮时、拔管前以及拔管后3 min,观察并记录心率、收缩压、舒张压。结果右美组收缩压、舒张压和心率均低于诱导前(P<0.05),其他各点之间无统计学差异。对照组心率、收缩压和舒张压波动大(P<0.05)。对照组心率、收缩压和舒张压于插管后3 min、切皮时与拔管后3 min较右美组高(P<0.01)。结论右美托咪啶能提高小儿脑瘤切除术麻醉血流动力学的稳定性。

Objective To evaluate the effect of dexmedetomidine（Dex） on hemodynamics in children undergoing brain tumor excision.Methods Totally 32 patients undergoing brain tumor excision under general anesthesia were randomly divided into Dex group and control group,16 each.In Dex group,the patients received intravenous injection of Dex（1 μg/kg） 10 min before intubation, and then received continuous injection of 0.5 μg/（kg·h） Dex during the operation.While in the control group,physiological saline was used instead of Dex.The systolic blood pressure（SBP）,diastolic blood pressure（DBP） and heart rate（HR） were continuously monitored at 6 different time points,namely before induction,before tracheal intubation,3 min after tracheal intubation,immediately after skin incision,before extubation and 3 min after extubation.Results In Dex group,SBP,DBP and HR were significantly higher before induction than the other time points（P〈0.05）,but showed no significant difference between other time points.In control group, SBP,DBP and HR showed greater fluctuations between all the time points（P〈0.05）.Compared with Dex group,the HR,SBP and DBP were increased more significantly in the control group 3 min after tracheal intubation,immediately after skin incision,3 min after extubation（P 0.01）.Conclusions The perfusion of Dex before induction and then continuous infusion of Dex can enhance the hemodynamic stability in children undergoing brain tumor resection.