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中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (11): 1272-1275.

• 药物治疗学 • 上一篇    下一篇

右美托咪定对全麻下妇科腹腔镜术围术期血动学及眼内压的影响

章玲宾1, 李晓芬2, 陈琴1, 游敏吉1, 吴伯乐3   

  1. 1 浙江省丽水市人民医院(温州医科大学附属第六医院)麻醉科,
    2 手术室,
    3眼科, 丽水323000,浙江
  • 收稿日期:2014-04-29 修回日期:2014-10-29 出版日期:2014-11-26 发布日期:2014-12-09
  • 作者简介:章玲宾,男,副主任医师,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(2010ZYC-A48); 丽水市公益性技术应用项目 (丽科[2012]A-69)

Effects of dexmedetomidine on hemodynamics and intraocular pressure of patients undergoing laparoscopic gynecological surgery during operation

ZHANG Ling-bin1, LI Xiao-fen2, CHEN Qin1, YOU Min-ji1, WU Bo-le3   

  1. 1 Department of Anesthesiology;
    2 Operating Room;
    3 Ophthalmology,Zhejiang Lishui People's Hospital, Sixth Affiliated Hospital of Wenzhou Medical College, Lishui 323000, Zhejiang,China
  • Received:2014-04-29 Revised:2014-10-29 Online:2014-11-26 Published:2014-12-09

摘要: 目的 观察右美托咪定对全麻下妇科腹腔镜术围术期血动学及眼内压(IOP)的影响。方法 80例ASA Ⅰ级择期行妇科腹腔镜手术患者,随机分为A、B、C、D 四组(n=20) ,A 组:采用喉罩全麻,麻醉诱导前 10 min 静脉泵注右美托咪定 0.6 μg/kg(10 min 注完) ; B 组:采用喉罩全麻,与A 组用同样方式输注等剂量0.9 % 氯化钠溶液; C 组:采用气管插管全麻,与A 组用同样方法应用右美托咪定; D 组:气管插管全麻,与C 组用同样方法应用等剂量 0.9%氯化钠溶液。观察记录四组患者在麻醉诱导前(T0)、麻醉诱导后(T1)、气管插管或插喉罩即刻(T2)、气腹并改变体位后 30 min(T3)、气管拔管或拔喉罩即刻(T4)时血压(BP)、心率(HR)、眼内压(IOP)的变化。结果 与T0 比较,T1 时A组、C组患者MBP、HR 和四组患者IOP明显降低 (P<0.01 或P<0.05),T2~T4时D组患者MBP、HR 、IOP明显增高 (P<0.01 或P<0.05);与A组比较,T2~T4时B、C、D组患者MBP、HR、IOP明显增高 (P<0.01 或P<0.05)。A组患者高血压、高眼压发生率低于B、C、D组(P<0.01),其中B、C组低于D组(P<0.01或P<0.05);B、D组心动过缓发生率低于A、C组(P<0.01)。结论 右美托咪定有助于稳定全麻下妇科腹腔镜术围术期血动学与眼内压,不延迟苏醒,尤其应用喉罩下情况下,值得推广。

关键词: 右美托咪定, 血动学, 眼内压, 妇科腹腔镜术

Abstract: AIM: To observe the effects of dexmedetomidine on hemodynamics and intraocular pressure for laparoscopic gynecological surgery. METHODS: 80 (ASA I )patients who undergoing elective laparoscopic gynecological surgery were randomly divided into four groups (Group A, B, C, D),n=20 in each group , group A: anesthesia using the laryngeal mask, 10 min before the induction of anesthesia, intravenous infusion dexmedetomidine 0.6 μg/kg (infusion within 10 min); group B :laryngeal mask anesthesia, intravenous infusion 0.9% sodium chloride solution in the same way with group A; group C: anesthesia with tracheal intubation, the application of dexmedetomidine in the same way with group A; group D: anesthesia with tracheal intubation, intravenous infusion 0.9% sodium chloride solution in the same way with group C. The blood pressure (BP), heart rate (HR), intraocular pressure (IOP) were observed and recorded at time points of before induction of anesthesia (T0), after induction of anesthesia (T1), immediately after endotracheal intubation or laryngeal mask (T2), and changes in position after pneumoperitoneum (T3), tracheal extubation or laryngeal mask poll out instantly (T4). RESULTS: MBP, HR, IOP had no significant differences among the four groups at T0 . The incidence of hypertension, high intraocular pressure in group A were lower than those of group B, C, D (P<0.01) , in which group B, C were lower than that of group D (P<0.01 or P<0.05). CONCLUSION: Dexmedetomidine can help stabilize the perioperative blood pharmacokinetics and intraocular pressure of gynecologic laparoscopic surgery under general anesthesia especially in the case of using laryngeal mask, besides do not delay waking. It is worth promoting.

Key words: dexmedetomidine, hemodynamic, intraocular pressure, laparoscopic surgery

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