右美托咪定联合达克罗宁对高血压患者全麻气管插管的影响

Effect of dexmedetomidin combined with dyclonine on intubation during general anesthesia in patients with hypertension

目的 :观察右美托咪定联合达克罗宁对高血压患者全麻气管插管的影响。方法 :选取择期行气管插管全麻手术的高血压患者120例,随机分为两组(各60例),DD组在麻醉诱导前微泵输注右美托咪定+涂抹达克罗宁,C组微泵输注生理盐水,两组均给予麻醉诱导气管插管,记录两组不同时间段应激反应的变化、苏醒期躁动评分、气管导管耐受程度及麻醉不良反应情况。结果 :在T0～T8时间段,DD组的HR、SBP及DBP水平变化较C组更接近正常值,且DD组SBP、HR在T1～T8时间段,DBP在T3～T8时间段较C组变化缓慢;术后,DD组的躁动评分和VAS评分明显低于C组,气管插管耐受度明显高于C组;在全麻气管插管及拔管期间,DD组躁动、咽喉疼痛明显减少,心动过缓较C组明显增多(P <0.05)。两组的声音嘶哑发生率比较无统计学意义(P> 0.05)。结论 :预注右美托咪定联合达克罗宁表麻对气管插管全麻高血压患者是安全有效的,能减轻气管插管及拔管期间的应激反应,对于减轻术后躁动有重要帮助。

Objective: To observe the effect of dexmedetomidin combined with dyclonine on intubation during general anesthesia in patients with hypertension. Methods: One hundred and twenty cases of patients undergoing general anesthesia under tracheal intubation in our hospital were selected and randomly divided into group DD and C with 60 cases each. The group DD was given dexmedetomidin infused by micropump and smeared with dyclonine before induction of anesthesia, while the group C was given physiological saline infused by micropump, and then the two groups were given anesthesia induction tracheal intubation. The changes of stress response at different time periods, restlessness score during recovery, tracheal intubation tolerance and adverse reactions caused by anesthesia in the two groups were recorded. Results: The levels of HR, SBP and DBP at T0-T8 time were more stable in the group DD than the group C and were closer to normal values. The changes of the levels of SBP and HR at T1-T8 time and DBP at T3-T8 time were slower and the postoperative restlessness score and VAS score were significantly lower while the tolerance of endotracheal intubation was significantly higher in the group DD than the group C (P<0.05). Agitation and sore throat were significantly reduced and bradycardia was significantly increased in the group DD than the group C during the tracheal intubation and extubation of the general anesthesia (P<0.05). However, there were no significant differences in the incidence of hoarseness between the two groups (P>0.05). Conclusion: The preinjection of dexmedetomidin combined with dyclonine surface anesthesia is safe and effective for the hypertension patients with tracheal intubation, which can relieve stress reaction during tracheal intubation and extubation, and is of benefit to reducing postoperative restlessness.