右美托嘧啶对颅内动脉瘤栓塞术患者全麻诱导期血流动力学的影响

Effects of dexmedetomidine on hemodynamics of the patients with intracranial aneurysm under going transcatheter embolization in induction period of general anesthesia

目的观察右美托嘧啶（DEX）对颅内动脉瘤栓塞术患者全麻诱导期血流动力学的影响。方法在笔者所在医院60例择期在全麻下行颅内动脉瘤血管内栓塞术患者（ASAⅠ-Ⅱ级），将其随机分为两组（n=30）：右美托咪啶组（D组），麻醉诱导前给予右美托嘧啶0．4μg／kg，静脉泵注，15min内完成；对照组（C组），诱导前给予同等量生理盐水静脉泵注，麻醉方法两组相同。分别记录泵注DEX或生理盐水前（T0），气管插管前（T1），气管插管即刻（T2），插管后1min（T3）、3min（T4）、5min（T5）6个时点收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）及心率（HR）的变化。结果D组Tl时点各指标较C组明显降低（P〈0．05），插管后T2、L和T4时点各指标均有上升趋势，上升幅度C组较D组明显（P〈0．05），L时点两组各指标无显著差异（P〉0．05）。结论右美托嘧啶可有效减少行颅内动脉瘤栓塞患者麻醉诱导期的血流动力学波动，降低了动脉瘤破裂的风险。

Objective To observe the effects of dexmedetomidine on hemodynamics of the patients with intracranial aneurysm under going transcatheter embolization in induction period of general anesthesia. Methods The Admitted in author＇s hospital the 60 patients with intracranial aneurysm（ASA Ⅰ-Ⅱ ） under going transcatheter embolization were randomly divided into control group （C） and dexmedetomidine group （D）,30 cases for each. Before the induction,the patients in the two groups received dexmedetomidine 0.4 μg/kg or equivalent normal saline with in 15 minutes,respectively. All the patients got the same anesthetics for induction. The parameters of systolic blood pressure （SBP）,diastolic pressure （DBP）,mean arterial pressure （MAP）,heart rate （HR） of every patient were recorded at the following time-points：before anesthesia induction （To）,before and immediately endotracheal intubation （Tl and T2）,l,3and 5 minutes after intubation （T3,T4 and T5）. Results Compared with group C,all parameters were lower at To. All paremeters of all patients rised. But the extent of rise in group C was obvious（P〈0.05）. There was no significant difference at T5（P〉0.05）. Conclusion Infusion of DEX is efficient to control the fluctuation of haemodynamics of induction perios in the patients under going transcatheter embolization for intracranial aneurysm. Accordingly the risk of aneurysm ruptured decreased.