摘要
目的探讨不同剂量右美托咪定(dexmedetomidine,DEX)复合依托咪酯行全身麻醉(全麻)诱导的麻醉效果。方法选取120例ASA分级Ⅰ~Ⅱ级择期全麻手术患者,随机分为4组(n=30):对照组(C组)、1.0μg/kgDEX组(D1组)、0.75μg/kg DEX组(D2组)、0.5μg/kgDEX组(D3组)。监测并记录DEX或生理盐水匀速静脉输注(注射)前(T0)、注射后(T1)、注射完成后5min(T2)、气管插管(插管)前(T3)、插管完成时(T4)、插管完成后2min(T5)、3min(T6)各时间点的平均动脉压(MBP)、心率(HR)、脉搏氧饱和度(SpO2)、脑电双频指数(BIS)值、镇静评分(OAA/S)等。结果c组患者气管插管前后HR、MAP、BIS上升显著,差异有统计学意义(P〈0.05)。与c组比较,在T1、T2时刻,D1-2组HR、BIS显著下降,差异有统计学意义(P〈0.05);T4-6时刻,D1-3组HR、MAP、BIS波动较小,差异有统计学意义(P〈0.05);D1-2组依托咪酯用量显著减少,差异有统计学意义(P〈0.05)。D1-3组麻醉苏醒无延迟,与C组比较差异无统计学意义(P〉0.05)。结论DEX复合依托咪酯行全麻诱导对维持患者血流动力学稳定有较好效果,且不影响全麻苏醒时间。
Objective To evaluate the general anesthesia induced by different doses of dexmedetomidine (DEX) combined with etomidate. Methods A total of 120 ASA Ⅰ~Ⅱ patients were enrolled in the current study who underwent surgery under general anesthesia condition. They were randomly divided into four groups (n = 30) : a control group (Group C), a 1.0 μg/kg Dex group (Group Dl ), a 0.75 μg/kg Dex group (Group D2) and a 0.5 μg/kg Dex group ( Group D3 ). The mean blood pressure (MBP) , heart rate (HR) , SPO2, bispectral index (BIS) , and Observer's assessment of alertness/sedation (OAA/S) scores were recorded before injection of Dex (TO ) , immediately after injection of DEX ( W1 ), 5 minutes after injection of Dex ( T2 ), before intubation ( T3 ), immediately after intubation ( T4 ), 2 and 3 minutes after the intubation ( T5 and T6 ). Results After intubation, patients in Group C produced remarkable increa- ses in HR, MAP, and BIS in comparison with those before intubation ( P 〈 0.05 ). Compared with Group C, HR and BIS were decreased markedly in Groups D1 and D2 at T1 and T2 ( P 〈 0.05 ). Groups D1 , D2, and D3 showed less changes in HR, MAP and BIS from W4 to T6 (P 〈 0. 05 ). The doses of etomidate used in Groups D1 and D2 were significantly reduced (P 〈 0.05 ). The recovery time of patients in Groups D1 , D2 and D3 were not extended, which were not statistical different from that of Group C (P 〉 0.05 ). Conclusion Dex combined with etomidate can stabilize patients' hemodynamic parameters under general anesthesia condition, and does not extend recovery time.
出处
《徐州医学院学报》
CAS
2015年第11期807-810,共4页
Acta Academiae Medicinae Xuzhou