右美托咪定用于全身麻醉剖宫产的效果

Efficacy of dexmedetomidine in Cesarean section under general anesthesia

目的评价右美托咪定用于全身麻醉(全麻)剖宫产的效果。方法全麻下行剖宫产产妇34例随机均分为两组:D组麻醉诱导前10min予负荷量右美托咪定0.6μg/kg,继以0.4μg·kg-1·h-1持续输注;N组泵入等体积的生理盐水。记录输注右美托咪定前(T0)、输注右美托咪定10min(T1)、气管插管(T2)、胎儿娩出(T3)、拔管(T4)和拔管后15min(T5)时的MAP和HR。胎儿娩出后抽取母体动脉血、脐静脉血进行血气分析,记录新生儿1-min、5-min Apgar评分。记录手术出血量、尿量,评估拔管质量和拔管后15min时寒战发生情况。结果 D组T2-T4时MAP和HR低于N组(P<0.05)。两组血气分析和新生儿Apgar评分相仿(P>0.05)。与N组比较,D组患者出血较少、尿量较多(P<0.05),拔管后15min时寒战发生率较低(P<0.05)。结论右美托咪定可增强全麻剖宫产的效果,稳定循环,而对新生儿无不良影响。

Objective To evaluate the efficacy of dexmedetomidine in Cesarean section under general anesthesia.Methods Thirty-four parturients scheduled for Caesarean section under general anesthesia were randomly and equally divided into two groups.Group D received an intravenous loading dose of dexmedetomidine 0.6μg/kg at 10 minutes before induction of anesthesia,which was followed by continuous infusion of dexmedetomidine 0.4μg·kg-1·h-1.Group N received same volume of normal saline instead of dexmedetomidine.MAP and HR were recorded before（T0）and at the end of loading infusion（T1）,at tracheal intubation（T2）,at the time of baby delivery（T3）and extubation（T4）,and 15 minutes after extubation（T5）.The maternal artery（MA）and umbilical vein（UV）blood gas analysis was performed.Apgar scores at 1-and 5-minute after delivery were recorded.The blood loss and urinany volume were recorded.The incidence of shivering at 15 minutes after extubation was evaluated.Results The MAP and HR at T2 to T4were lower in group D than those in group N（P〈0.05）.There were no significant differences in blood gas analysis of MA and UV,and the Apgar scores of neonates after delivery between two groups（P〉0.05）.Compared with group N,group D had less blood loss（P〈0.05）,more urinary volume（P〈0.05）,and lower incidence of shivering after extubation（P〈0.05）.Conclusion Dexmedetomidine infusion during Cesarean section under general anesthesia can enhance anesthetic effects and stablize the circulation without adverse effects on neonates.