右美托咪定对高海拔地区窦性心动过缓患者手术安全性及有效性的观察

Safety and Effectiveness of Dexmedetomidine for Surgery in Patients with Sinus Bradycardia at High Altitude

目的探讨右美托咪定对高海拔地区(海拔2295m)窦性心动过缓患者全身麻醉时血压和心率的影响,为高海拔地区安全使用右美托咪定提供依据。方法选取青海省人民医院2014年5月至2016年5月需全麻手术的窦性心动过缓患者100例,根据麻醉方法不同随机分为2组:观察组(右美托咪定组)及对照组。观察2组患者入手术室时(T1),药物输注10min时(T2),气管插管后即刻(T3)、术毕(T4)、拔管后即刻(T5)的收缩压(SBP)、舒张压(DBP)及心率(HR)。结果不同麻醉方法间SBP、DBP及HR比较有统计学差异(P<0.05),相同麻醉方法的不同时间点比较SBP、DBP及HR有统计学差异(P<0.05),两组的SBP、DBP及HR变化趋势不同(P<0.05),且观察组患者SBP、DBP及HR变化趋势平稳。结论高海拔地区窦性心动过缓患者在接受手术时,右美托咪定能够使其循环系统的变化更趋于稳定,可有效抑制全麻的心血管反应。

Objective To investigate the safety of dexmedetomidine and its effect on blood pressure and heart rate of patients with sinus bradycardia during general anesthesia at high altitude.Methods One hundred patients with sinus bradycardia who needed general anesthesia were selected in Qinghai Provincial People′s Hospital between May 2014 and May 2016.They were randomly assigned to two groups according to anesthetic methods：dexmedetomidine group and control group.The changes of SBP,DBP and HR of these patients were observed upon their admission into the operating room（T1）,10 min after drug infusion（T2）,upon endotracheal intubation（T3）,at the end of operation（T4）,and immediately after extubation（T5）.Results SBP,DBP and HR of dexmedetomidine group were significantly different from those of control group（P 〈0.05）.SBP,DBP and HR of patients anesthesized in the same way were significantly different at different time points（P 〈0.05）.The way SBP,DBP and HR changed was considerably different between the two groups（P〈 0.05）,but the change in dexmedetomidine group was gradual.Conclusion Dexmedetomidine can help stablize circulation among patients with sinus bradycardia during surgery and inhibit cardiovascular response to general anesthesia at high altitude.