右美托咪定对高血压全麻患者围拔管期应激反应的影响

中国临床药理学与治疗学 ›› 2011, Vol. 16 ›› Issue (11): 1288-1291.

右美托咪定对高血压全麻患者围拔管期应激反应的影响

章玲宾¹, 樊理华¹, 卢向红¹, 楼天正¹, 何仁洪¹, 陈琴¹, 游敏吉¹, 丁友法²

¹浙江省丽水市人民医院(温州医学院附属第六医院)麻醉科,
²检验科,丽水 323000,浙江

收稿日期:2011-10-09 修回日期:2011-11-04 出版日期:2011-11-26 发布日期:2011-11-29
作者简介:章玲宾,男,主治医师,研究方向:围术期重要脏器的功能保护和应激反应的预防。Tel: 18957090895 E-mail: lszhanglingbin@126.com
基金资助:
浙江省医学会临床科研项目(项目编号2010ZYC-A48)

Effects of dexmedetomidine on patients with anesthesia hypertension about stress reaction between the extubation period

ZHANG Ling-bin¹, FAN Li-hua¹, LU Xiang-hong¹, LOU Tian-zheng¹, HE Ren-hong¹, CHEN Qin¹, YOU Min-ji¹, DING You-fa²

¹Department of Anesthesiology,
²Clinical Laboratory,Lishui People's Hospital of Zhejiang (the Sixth Affiliated Hospital of Wenzhou Medical College), Lishui 323000, Zhejiang ,China

Received:2011-10-09 Revised:2011-11-04 Online:2011-11-26 Published:2011-11-29

摘要/Abstract

摘要： 目的: 观察右美托咪定(dexmedetomidine,Dex)对高血压全麻患者围拔管期应激反应的影响。方法: 选择既往有高血压病史,血压控制稳定,择期行胃癌根治手术的患者60 例。随机分成右美托咪定 0.5 μg/kg 组(D₁组)、右美托咪定 1 μg/kg 组( D₂组) 和生理盐水对照组 ( C组) ,每组20例。均采用静吸复合全麻,手术结束前 60 min 分别静脉微泵注射右美托咪定 0.5 μg/kg、1 μg/kg、生理盐水 20 mL,输注时间 30 min。于麻醉前、拔管前、拔管后1、3、5、10 min 记录血流动力学参数,测定血浆肾上腺素(E) 、去甲肾上腺素(NE)、皮质醇(COR)、血糖(GLU)、血乳酸(LAC)浓度, 并记录手术麻醉时间、唤醒时间、拔管时间。结果: 三组患者围拔管期间平均动脉压(MAP)、心率(HR)数值和血浆E、NE、COR、GLU、LAC浓度均比麻醉前明显增高( P<0.01 或P<0.05);与D₁组、D₂组比较,C组的 MAP、HR、E、NE、COR、GLU、LAC明显增高(P<0.01 或P<0.05);D₂组的唤醒时间、拔管时间明显长于C组和D₁组(P<0.05)。结论: 右美托咪定能明显抑制气管拔管期引起的应激反应,以 0.5 μg/kg 更为合适。

关键词: 围拔管期, 应激反应, 右美托咪定

Abstract: AIM: To observe the effect of dexmedetomidine on patients with anesthesia hypertension about stress reaction between the extubation period.METHODS: 60 patients with previous history of hypertension, stable blood pressure control, gastric cancer surgery were enrolled in the research. The patients were randomly divided into dexmedetomidine 0.5 μg/kg group (group D₁), dexmedetomidine 1 μg/kg group (group D₂) and saline control group (group C), n=20. All the patients were used inhalation anesthesia. Dexmedetomidine 0.5 μg/kg,1 μg/kg, and normal saline 20 mL were given with micro-pumps intravenous inject at 60 min before the end of surgery,the infusion time was 30 min. Before anesthesia, before extubation, after extubation 1,3,5,10 min ,the hemodynamic parameters were recorded,the levels of plasma epinephrine (E), norepinephrine (NE), cortisol (COR), glucose (GLU), blood lactate (LAC)were determined, and the levels of lanesthesia time, wake time, extubation time were recorded.RESULTS: The levels of MAP, HR,plasma E, NE, COR, GLU, LAC in three groups were significantly higher than those of before anesthesia (P<0.01 or P<0.05). The levels of MAP, HR,plasma E, NE, COR, GLU, LAC in group C were higher than those of group D₁, group D₂ (P<0.01 or P<0.05). The levels of wake-up time, extubation time in group D₂ were higher than those of group C , group D₁ (P<0.05).CONCLUSION: Dexmedetomidine can inhibit the stress response which is caused by tracheal extubation,and the appropriate dose is 0.5 μg/kg.

Key words: Extubation period, Stress response, Dexmedetomidine

中图分类号:

R614

章玲宾, 樊理华, 卢向红, 楼天正, 何仁洪, 陈琴, 游敏吉, 丁友法. 右美托咪定对高血压全麻患者围拔管期应激反应的影响[J]. 中国临床药理学与治疗学, 2011, 16(11): 1288-1291.

ZHANG Ling-bin, FAN Li-hua, LU Xiang-hong, LOU Tian-zheng, HE Ren-hong, CHEN Qin, YOU Min-ji, DING You-fa. Effects of dexmedetomidine on patients with anesthesia hypertension about stress reaction between the extubation period[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(11): 1288-1291.

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