右美托咪定诱导对经鼻蝶垂体瘤手术围术期的影响

Effects of dexmedetomidine-induction on transsphenoidal pituitary tumor surgery perioperative

目的探讨右美托咪定诱导对经鼻蝶垂体瘤手术围术期的影响。方法选择2013年3月—2016年5月温州医科大学附属第五医院麻醉科经鼻蝶垂体瘤手术患者50例作为研究对象,根据随机数字法将其分为右美托咪定组和对照组各25例,右美托咪定组在诱导前15 min经静脉泵入右美托咪定,对照组在诱导前15 min经静脉泵入等量生理盐水,观察2组患者各时间点收缩压、舒张压和心率变化以及2组患者瑞芬太尼和丙泊酚用量、手术时间和拔管时间。结果右美托咪定组插管后5 min、拔管后5 min和拔管后10 min收缩压均低于对照组相应时间点收缩压(P<0.05)。右美托咪定组插管后5 min、拔管后5 min和拔管后10 min舒张压均低于对照组相应时间点舒张压(P<0.05)。右美托咪定组插管前、插管后5 min和拔管后5 min心率均低于对照组相应时间点心率(P<0.05)。右美托咪定组和对照组瑞芬太尼和丙泊酚用量比较差异无统计学意义(P>0.05)。右美托咪定组手术时间和拔管时间和对照组比较差异无统计学意义(P>0.05)。结论右美托咪定诱导有利于经鼻蝶垂体瘤手术患者围手术期收缩压、舒张压和心率的稳定,并且不影响麻醉药用量、手术时间和拔管时间。

Objective To study the effects of dexmedetomidine-induction on transsphenoidal pituitary tumor surgery perio- perative. Methods Fifty patients from the Fifth Affiliated Hospital of Wenzhou Medical Anesthesiology transsphenoidal pituitary tumor surgery were selected as research subjects, the 50 patients were divided into dexmedetomidine group and control group according to the random number method, the dexmedetomidine group patients were pumped dexmedetomidine intravenously at 15 minutes before induction, the control group patients were pumped saline intravenously at 15 minutes before induction. The systolic, diastolic blood pressure and heart rate of two groups were observed at all time points, the remifentanil and prop propofol dosage, operation time and extubation time of two groups as well as were observed. Results The systolic blood pressure of dexmedetomidine group at 5 min after intubation,5 min after extubation and 10 min after extubation were lower than that of control group corresponding time points （P 〈 0.05 ）. The diastolic blood pres- sure of dexmedetomidine group at 5 min after intubation, 5 min after extubation and 10 min after extubation were lower than that of control group corresponding time points（ P 〈 0. 05 ）. The heart rate of dexmedetomidine group at before intuba- tion ,5 min after intubation and 5 min after extubation were lower than that of control group corresponding time points （P 〈 0.05 ）. The difference of remifentanil and prop propofol dosage in dexmedetomidine group and control group were not sta- tistically significant（P 〉 0.05）. The difference of operation time and extubation time in dexmedetomidine group and con- trol group were not statistically significant （ P 〉 0. 05 ）. Conclusion Dexmedetomidine induced is beneficial to favor transsphenoidal pituitary tumor surgery perioperative systolic blood pressure, diastolic blood pressure and heart rate stable and does not affect the amount of anesthetic, surgical time and extubation time.