右美托咪啶对老年全麻骨科手术围拔管期心血管反应的影响

Cardiovascular Responses of Dexmedetomidine Anesthesia during Extubation in Orthopedic Surgery in Elderly Patients

目的:观察右美托咪啶对老年全麻骨科手术围拔管期心血管反应的影响。方法:将90例全麻老年骨科手术患者分为右美托咪啶低剂量组(D1组),右美托咪啶高剂量(D2组)及对照组(C组),记录给药前(T0)、给药后5 min(T1)、拔管前(T2)、拔管即刻(T3)、拔管后5 min(T4)患者的收缩压(SBP)、舒张压(DBP)、心率(HR)及自主呼吸恢复时间、苏醒时间、拔除气管导管时间、降压药物使用率。结果:D1、D2组T1、T3时的HR、SBP、DBP变化明显大于T0,D1、D2组T1、T3时的HR、SBP、DBP变化明显低于C组(P<0.05)。D1、D2组的苏醒时间和D2组的拔除气管导管时间均明显长于C组,D1、D2组的降压药物使用率明显低于C组(P<0.05)。结论:右美托咪啶用于全麻老年骨科手术能减轻血流动力学变化,减少拔管期心血管应激反应。

Objective To observe the cardiovascular responses of dexmedetomidine anesthesia in elderly or- thopedic surgery during extubation. Methods Ninety elderly patients undergoing orthopedic surgery anesthe- sia were divided into the low dosage of dexmedetomidine group （Dx group ） , the high dosage of dexmedetomidine group （D2 group ） and control group （C group ）. The systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） and spontaneous breathing recovery time , recovery time, extubation time, antihyperten- sive drugs usage were recorded before administration （T0）, 5min after administration （T0, before extubation （T2）, tracheal extubation （T3） and after extubation 5rain （T4）. Results In D1 and D2 groups during TI and T3 the HR, SBP and DBP changed significantly greater than those in T0,but significantly lower than those in C group （P 〈 0.05）. In D1 and D2 groups the recovery time and in D2 group group the extubation time were significantly longer than those in group C. In D1 and D2 groups the antihypertensive medication usage was significantly lower than that in group C （P 〈 0.05）. Conclusion Dexmedetomidine anesthesia for orthopedic surgery can allevi- ate elderly hemodynamics , reduce cardiovascular stress response during extubation