右美托咪啶对止血带引起下肢缺血-再灌注损伤的保护作用

Protective effect of dexmedetomidine on tourniquet-induced ischemia-reperfusion injury of lower limbs

目的探讨右美托咪啶对止血带引起肢体缺血-再灌注(I-R)损伤的保护作用。方法在腰-硬联合麻醉下行择期骨科下肢手术患者28例分为两组:D组15例,麻醉前10min内静脉输注右美托咪啶0.6-0.8μg/kg,继之以0.3-0.5μg·kg-1·h-1维持,直至术毕前15min。C组13例,不用右美托咪啶作为对照。检测麻醉前(T0)、止血带充气后30min(T1)和止血带放气后5min(T2)、30min(T3)血浆肌酸磷酸激酶(CK)和乳酸脱氢酶(LDH)活性。结果 T2、T3时,C组血浆CK和LDH高于术前(P<0.05),D组血浆CK和LDH低于C组(P<0.05)。结论右美托咪啶可以减轻止血带引起肢体I-R损伤。

Objective To investigate the protective effects of dexmedetomidine on tourniquetinduced ischemia-reperfusion（I-R）injury of the lower limbs.Methods Twenty-eight patients undergoing orthopedic surgery of the lower limbs under conbined spinal-epidural anesthesia were randomly assigned into two groups.The patients in group D（15 caes）were infused dexmedetomidine0.6-0.8μg/kg in 10 minutes before anesthesia,which was followed by infusion of dexmedetomidine0.3-0.5μg·kg-1·h-1 till 30 min before the end of operation.Dexmedetomidine was not used in group C（13cases）as the control.Plasma LDH and CK were detected before anesthesia（T0）,at 30 minutes after tourniquet inflationa（T1）,5minutes（T2）and 30 minutes（T3）after tourniqut deflation.Results Plasma levels of CK and LDH at T2 and T3 in group C were significantly higher than those at T0（P〈0.05）,which were lower in group D than those in group C（P〈0.05）.Conclusion Dexmedetomidine can effectively attenuate tourniquet-induced I-R injury of the lower limbs.