右美托咪定对糖尿病患者全麻诱导期间心率变异性的影响

Effect of dexmedetomidine on heart rate variability during induction of general anesthesia in diabetic patients

目的观察右美托咪定对糖尿病患者全麻诱导期间心率变异性(HRV)的影响。方法糖尿病患者50例,随机均分为两组:D组麻醉诱导前10min内静脉泵注负荷量右美托咪定0.5μg/kg,继以0.2μg·kg-1·h-1持续泵注至插管后5min;C组给予等剂量生理盐水。记录并分析两组患者静息时(T0)、负荷量结束(T1)、气管插管前即刻(T2)以及插管后1min(T3)、3min(T4)和5min(T5)时的HR、MAP和HRV频域指标变化。结果D组T1-T5时较T0时HR减慢、MAP降低(P<0.05)。与C组比较,D组T3时的HR减慢、T1时的MAP降低(P<0.05)。D组T3-T5时的低频和高频值较T1时升高(P<0.05)。结论右美托咪定对糖尿病患者全麻诱导过程中的HRV影响小,并能有效抑制气管插管反应。

Objective To explore the effect of dexmedetomidine on heart rate variability（HRV）during induction of general anesthesia in the patients with diabetes mellitus（DM）.Methods A total of50 cases with DM was equally and randomly divided into two groups.The patients in group D were infused dexmedetomidine 0.5μg/kg as a loading dose in 10 min before anesthesia induction,which was followed by infusion of dexmedetomidine 0.2μg·kg^-1·h^-1 untill 5min after intubation.Normal saline instead of dexmedetomidine was infused in group C.HR,MAP and HRV were recorded and analyzed at the resting（T0）,the end of loading dose（T1）,the time right before tracheal intubation（T2）,and at1min（T3）,3min（T4）and 5min（T5）after intubation.Results HR and MAP in group D were lower at T1-T5 than those at T0（P〈0.05）.HR and MAP at T3 and T1were lower in group D than those in group C（P〈0.05）.The values of low frequency and high frequency were increased at T3-T5 than those at T1 in group D（P〈0.05）.Conclusion Dexmedetomidine has no significant effect on HRV during induction of general anesthesia in the patients with DM and can effectively restrain the stress response of trachea intubation.