地佐辛复合右美托咪定用于高血压患者全麻诱导的效果

Clinical Effect of Dezocine and Dexmedetomidine Used for Induction of General Anesthesia on Patients with Hypertension

目的：观察地佐辛复合右美托咪定用于高血压患者乳腺癌手术全麻诱导的临床效果。方法：选择我院择期行乳腺癌改良根治术的患者90例,随机分为Ⅰ、Ⅱ、Ⅲ组,n=30。Ⅰ组给予芬太尼2~5μg/kg,Ⅱ组给予地佐辛0.2~0.3 mg/kg,Ⅲ组持续输注右美托咪定1μg/（kg·h）10 min后给予地佐辛0.2~0.3 mg/kg,三组患者均常规行全麻诱导。记录围插管期的平均动脉压（MAP）、心率（HR）,并测定T0、T1、T2、T3时血浆肾上腺素（E）和去甲肾上腺素（NE）的浓度,同时记录患者拔管即刻、拔管后1 min的MAP、HR及术中给予的心血管活性药物的总剂量等情况。结果：Ⅰ组患者MAP、HR在T1、T2、T5时刻的数值及围插管期血浆肾上腺素（E）和去甲肾上腺素（NE）浓度变化分别与其前一时点相比,差异有统计学意义（P〈0.05）。Ⅱ、Ⅲ两组围插管期血浆肾上腺素（E）和去甲肾上腺素（NE）浓度虽然都有波动,但与前一时点比较差异均无统计学意义（P〉0.05）。结论：地佐辛复合右美托咪定用于高血压患者乳腺癌手术全麻诱导不仅可以有效抑制气管插管应激反应,维持术中血流动力学稳定,降低患者术后对疼痛的敏感性,而且对患者术后意识、呼吸等恢复没有影响。

Objective： To observe the clinical effect of dezocine and dexmedetomidine used for induction of general anesthesia on patients undergoing breast cancer surgery who had hypertension. Methods： Nighty patients of breast cancer needed to surgery in our hospital were randomly divided into group Ⅰ, Ⅱ, Ⅲ with 30 cases each. Anesthesia were induced conventional plus fentany 2~5 μg/kg（groupⅠ）, dezocine 0.2~0.3 mg/kg（groupⅡ）, dexmedetomidine 1 μg/（kg·h）10 min and dezocine 0.2~0.3 mg/kg（group Ⅲ）. The mean artery pressure（MAP） and heart rate（HR） were recorded at the time of around the intubation, immediately extubation, 1 min after extubation. The plasma concentrations of epinephrine（E） and norepinephrine（NE） were tested at T0, T1, T2, T3. The total doses of cardiovascular drugs were recorded at the same time. Results： MAP and HR at T1, T2, T5 and the epinephrine（E） and norepinephrine（NE）of groupⅠwas significantly different from those at the previous point（P〈0.05）. The epinephrine（E） and norepinephrine（NE） of groupⅡ, Ⅲ had no difference from those at the previous point（P〉0.05）. Conclusion： Dezocine and dexmedetomidine used for induction of general anesthesia on patients undergoing breast cancer surgery who had hypertension not only can effectively restrain the stress reaction of trachea intubation, maintain the stability of intraoperative hemodynamic, reduce the postoperative sensitivity to pain, but also has no effect on recovery of consciousness and breath of patients.