右美托咪定对高血压患者术后血压昼夜节律的影响

Effects of dexmedetomidine on postoperative blood pressure circadian rhythm in patients with hypertension

目的探讨高血压患者麻醉术后血压昼夜节律的变化及给予右美托咪定后是否可以降低此变化的波动。方法随机选取我院2017月12月~2018年12月收治的60例拟行腹腔镜下胆囊切除术的患者为本次研究对象。随机分为右美托咪定组(D组:麻醉诱导前泵注右美托咪定0.5μg/(kg·10min)负荷剂量,术中以0.2μg/(kg·h)的速度持续泵注至手术结束前30min,给予术后镇痛泵舒芬太尼2μg/kg+右美托咪定2μg/kg+阿扎司琼10mg^100mL)和对照组(C组:给予等容积的生理盐水,给予术后镇痛泵舒芬太尼2μg/kg+阿扎司琼10mg^100mL),比较两组术后血压昼夜节律及应用右美托咪定对术后血压昼夜节律的影响。结果D组术中血流动力学较C组稳定,C组术后血压昼夜节律较术前紊乱,而D组术前术后无明显变化。结论右美托咪定不仅可以维持术中血流动力学的稳定还可改善术后血压昼夜节律的变化。

Objective To explore changes of blood pressure circadian rhythm after anesthesia in patients with hypertension and whether the fluctuation of this change can be reduced after dexmedetomidine is administered.Methods 60 patients who were admitted and were planning to undergo laparoscopic cholecystectomy in our hospital from December 2017 to December 2018 were randomly selected as research objects.According to the random principle,they were divided into the dexmedetomidine group(group D:The loading dose of dexmedetomidine was injected 0.5 microns/(kg·10min)before anesthesia induction.During the operation,the pump was continuously injected at the rate of 0.2 micron/(kg·h)until 30 min before the end of the operation.The pump was given sufentanil 2μg/kg and dexmedetomidine 2μg/kg and azasetron 10 mg to 100 mL for postoperative analgesia)and the control group(group C:They were given an equal volume of saline.The pump was given sufentanil 2μg/kg and azasetron 10 mg to 100 mL for postoperative analgesia).Blood pressure circadian rhythm and effects of dexmedetomidine on postoperative blood pressure circadian rhythm were compared between two groups.Results Hemodynamics in group D was more stable than group C.The blood pressure circadian rhythm was more disturbed in group C,while there was no significant change in group D.Conclusion Dexmedetomidine can not only maintain the stability of intraoperative hemodynamics but also improve the changes of circadian rhythm of blood pressure after operation.