右美托咪定对肝包虫病手术患者血流动力学的影响

Effect of dexmedetomidine on hemodynamics in patients with hepatic hydatid surgery

目的探讨右美托咪定对肝包虫病手术患者血流动力学的影响。方法择期行肝包虫病手术ASAⅠ~Ⅱ级患者40例,年龄25~60岁,随机分为右美托咪定组(D组)与对照组(C组),每组20例。D组在麻醉诱导前,采用微量泵在10 min内泵注0.8μg/kg右美托咪定,然后以0.3μg·kg-1·h-1的速度维持至手术结束;C组输注等量生理盐水。麻醉方法相同,观察并记录入室后(T0)、药物输注10 min(T1)、气管插管后即刻(T2)、术中囊肿切除时(T3)、术毕(T4)、拔管后即刻(T5)、拔管后10 min(T6)的收缩压(SBP)、舒张压(DBP)、心率(HR),同时观察记录患者拔管时间、定向力恢复时间及术后恶心呕吐、寒战等不良反应情况。结果 D组在T1~T6时SBP、DBP、HR明显低于C组(P<0.05);D组拔管时间明显短于C组,术后恶心呕吐、寒战的发生率明显低于C组(P<0.01)。结论右美托咪定复合全麻在肝包虫病患者的手术中,能够使血流动力学更趋于稳定,更有利于患者术后的苏醒和康复。

Objective To investigate the effects of dexmedetomidine on hemodynamics in patients with hepatic hydatid surgery. Methods Forty patients of aged 25-60 years, ASAⅠ-Ⅱ, performed hepatic echinococcosis surgey, were randomly divided into group D(dexmedetomidine group n=20) and group C(control group n=20). Before anesthesia induction, dexmedetomidine 0.8 μg/kg were intravenous pumped within 10 minutes in group D and 0.3 μg·kg-1·h-1 until operation finished, and 0.9% sodium chloride injection were equally given in group C. SBP, DBP and HR were recorded after entering the operating room(T0), after 10 min infusion(T1), immediately after tracheal intubation(T2), cyst resection(T3), end of operation(T4), immediately after tracheal extubation(T5) and after 10 min tracheal extubation(T6). The tracheal extubation time, orientation recovery time and any adverse reactions including nausea, vomiting, and chills were recorded also. Results The SBP, DBP and HR at T1-T6 were significantly lower in group D than that of group C(P<0.01). The tracheal extubation time and adverse reactions including nausea, vomiting and chills of group D were significant lower than those of group C(P<0.01). Conclusion Application of dexmedetomidine in hepatic echinococcosis surgery can maintain more hemodynamic stability, more conducive to the recovery and rehabilitation of patients after surgery.