全麻诱导前应用小剂量右美托咪定防止术中心律失常与血压升高的临床研究

Clinical study of low dose of dexmedetomidine before induction of general anesthesia in preventing intraoperative arrhythmia and blood pressure elevation

目的观察全麻诱导前应用小剂量右美托咪定对血流动力学与血压的影响。方法将2015年6~12月在我院行全麻手术的患者94例随机分为观察组和对照组,各47例。对照组采用传统全麻方法,观察组在全麻诱导前给予0.5μg/kg负荷剂量的盐酸右美托咪定,持续泵入10 min,之后方法与对照组同。比较两组患者在麻醉前后半小时收缩压与心率变化情况和术中并发症发生率。结果两组患者在麻醉前半小时收缩压与心率情况比较,差异无统计学意义（P〉0.05）。两组患者在麻醉后半小时收缩压与心率变化情况比较,差异有统计学意义（P〈0.05）。观察组术中并发症发生率明显低于对照组,差异有统计学意义（P〈0.05）。结论全麻诱导前开始持续输注小剂量右美托咪定,具有一定的镇静、镇痛作用,使患者在手术中和拔管前后的血流动力学水平变化较小,提高手术麻醉安全性,降低不良反应发生率,取得了理想的麻醉效果。

Objective To observe the effects of low dose of dexmedetomidine before induction of general anesthesia on hemodynamics and blood pressure. Methods 94 cases of patients under general anesthesia in our hospital from June 2015 to December 2015 were randomly divided into observation group and control group of 47 eases, respectively. The control group was treated by conventional general anesthesia,While in the observation group, a dose of 0.5mg/kg of dexmedetomidine hydrochloride was given and continued for 10 minutes before the induction of general anesthesia, fol- lowed by the same method as the control group. The changes of systolic blood pressure （SBP） and heart rate （HR） before and after half of an hour of anesthesia and the incidence of intraoperative complications were compared between the two groups. Results There was no significant difference in systolic blood pressure and heart rate between the two groups before anesthesia（P〉0.05）. While the difference in systolic blood pressure and heart rate between the two groups after anesthesia was statistically significant（P〈0.05）. The incidence of complications in the observation group was significantly lower than that of the control group, and the difference between, the two groups was statistically signifieant（P〈0.05）. Conclusion Continuous intravenous infusion of low-dose dexmedetomidine before induction of general anesthesia can provide appropriate sedation,analgesic effect,allowing patients to maintain small hernodynamics changes in the surgery and before and after extubation,with improved safety of anesthesia and reduced incidence of adverse reactions.and can achieve the desired anesthetic effect.