右美托咪定改善重症肌无力患者全麻手术中血压、心率和苏醒质量的影响

Dexmedetomidine Improved Blood Pressure and Heart Rate during General Anesthesia and Recovery Quality in Patients with Myasthenia Gravis

目的探讨全麻手术中右美托咪定改善重症肌无力患者的血压、心率和苏醒质量的影响。方法选取2018年2月至2019年2月贵州省铜仁市人民医院收治的80例重症肌无力患者,采用随机数字表法分为两组,各40例。在进行常规全麻前,实验组患者给予静脉注射右美托咪定0.5μg.㎏-1.h-1,对照组患者给予静脉注射0.5μg.㎏-1.h-1的生理盐水。分别记录麻醉前(T1)、插管时(T2)、切皮时(T3)、劈胸骨时(T4)、拔管时(T5)5个时段的血压和心率,以及患者自主呼吸恢复时间、呼之睁眼时间、意识完全清醒时间、拔管时间。结果实验组患者T2-T5时血压、心率均低于T1时,且低于同期对照组,差异有统计学意义(P<0.05)。与对照组比较,实验组患者的自主呼吸恢复时间、呼之睁眼时间、完全清醒时间以及拔管时间均减少,差异有统计学意义(P<0.05)。结论在重症肌无力患者的全麻手术中,右美托咪定可降低患者血压,减少心率,改善苏醒质量。

Objective To investigate the effect of dexmedetomidine on blood pressure and heart rate during general anesthesia and recovery quality in patients with myasthenia gravis.Methods A total of 80 patients with myasthenia gravis admitted to the Department of Critical Care Medicine,Tongren People's Hospital of Guizhou Province from February 2018 to February 2019 were randomly divided into two groups,40 cases in each group.The experimental group was given dexmedetomidine 0.5μg.㎏1.h1 intravenously before general anesthesia,while the control group was given 0.5μg.㎏1.h1 saline intravenously before general anesthesia.Blood pressure and heart rate were recorded before anesthesia(T1),intubation(T2),skin incision(T3),sternal chopping(T4),extubation(T5),as well as recovery time of spontaneous breathing,the time of open eyes,the time of full consciousness and the time of extubation.Results The blood pressures and heart rates of T2-T5 in the experimental group were lower than T1 and than those in the control group at the same timepoint(P<0.05).The recovery time of spontaneous breathing,the time of open eyes,the time of full consciousness and the time of extubation of patients in the experimental group was significantly lower than those in the control group(P<0.05).Conclusion In general anesthesia for patients with myasthenia gravis,dexmedetomidine can decrease blood pressure and heart rate,improve recovery quality of patients.