国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2011年
3期
269-272
,共4页
许奎斌%李希才%崔刚%柴富%张铁铮
許奎斌%李希纔%崔剛%柴富%張鐵錚
허규빈%리희재%최강%시부%장철쟁
盐酸右美托咪啶%气管拔管%咳嗽%心血管副作用
鹽痠右美託咪啶%氣管拔管%咳嗽%心血管副作用
염산우미탁미정%기관발관%해수%심혈관부작용
Dexmedetomidine hydrochloride%Extubation%Cough%Adverse cardiovascular response
目的 观察盐酸右美托咪啶对全麻气管拔管时心血管反应的预防作用.方法 全麻行胃肠道手术的患者100例,性别不限,ASAⅡ或Ⅲ级,年龄30岁～60岁;体重(kg)在标准体重±20%,采用随机数字表法将患者为2组(每组50例):丙泊酚组(P组)和盐酸右美托咪啶组(D组).术毕患者转入麻醉后恢复室,P组靶控输注丙泊酚,血浆靶浓度设定为1 mg/L,D组静注盐酸有美托咪啶负荷与维持剂量分别为0.5μg/kg(10 min注射完毕)、0.5μg·kg-1·h-1,两组均于自主呼吸恢复时停药.记录术前(T0)、转入麻醉后恢复室即刻(T1)、给药后10 min(T2)、自主呼吸恢复(T3)、拔管时(T4)、拔管后10 min(T5)的血压(BP)、心率(HR)和咳嗽反应情况.记录呼气末麻醉药浓度,自主呼吸恢复时间、呼唤睁眼时间、拔管时间、视觉模拟评分和副作用情况.结果 D组,收缩压(SBP)、舒张压(DBP)和HR在T4分别为(124±15)、(79±11)、(74±10)mmHg(1 mm Hg=0.133 kPa);P组为(143±21)、(87±13)、(93±8)mm Hg(P<0.05).D组,SBP、DBP和HR在T5分别为(120±14)、(75±8)、(75±9)mm Hg;P组为(128±22)、(80±12)、(83±10)mm Hg(P<0.05).D组,自主呼吸恢复时间和呼唤睁眼时间分别为(4±3)、(4±4)min,P组为(6±5)、(8±5)min(P<0.05).拔管时D组发生重度咳嗽3例,P组23例(P<0.05).拔管后D组视觉模拟评分为(3.6±2.0),P组为(5.5±3.1)(P<0.05).与T0比较,P组SBP、DBP在Td分别为(143±21)、(87±13)mmHg(P<0.05);HR在T4和T5分别为(93±8)、(83±10)次/分(P<0.05).结论 盐酸右美托咪啶能有效预防全麻拔管时的心血管反应,提高拔管质量.
目的 觀察鹽痠右美託咪啶對全痳氣管拔管時心血管反應的預防作用.方法 全痳行胃腸道手術的患者100例,性彆不限,ASAⅡ或Ⅲ級,年齡30歲～60歲;體重(kg)在標準體重±20%,採用隨機數字錶法將患者為2組(每組50例):丙泊酚組(P組)和鹽痠右美託咪啶組(D組).術畢患者轉入痳醉後恢複室,P組靶控輸註丙泊酚,血漿靶濃度設定為1 mg/L,D組靜註鹽痠有美託咪啶負荷與維持劑量分彆為0.5μg/kg(10 min註射完畢)、0.5μg·kg-1·h-1,兩組均于自主呼吸恢複時停藥.記錄術前(T0)、轉入痳醉後恢複室即刻(T1)、給藥後10 min(T2)、自主呼吸恢複(T3)、拔管時(T4)、拔管後10 min(T5)的血壓(BP)、心率(HR)和咳嗽反應情況.記錄呼氣末痳醉藥濃度,自主呼吸恢複時間、呼喚睜眼時間、拔管時間、視覺模擬評分和副作用情況.結果 D組,收縮壓(SBP)、舒張壓(DBP)和HR在T4分彆為(124±15)、(79±11)、(74±10)mmHg(1 mm Hg=0.133 kPa);P組為(143±21)、(87±13)、(93±8)mm Hg(P<0.05).D組,SBP、DBP和HR在T5分彆為(120±14)、(75±8)、(75±9)mm Hg;P組為(128±22)、(80±12)、(83±10)mm Hg(P<0.05).D組,自主呼吸恢複時間和呼喚睜眼時間分彆為(4±3)、(4±4)min,P組為(6±5)、(8±5)min(P<0.05).拔管時D組髮生重度咳嗽3例,P組23例(P<0.05).拔管後D組視覺模擬評分為(3.6±2.0),P組為(5.5±3.1)(P<0.05).與T0比較,P組SBP、DBP在Td分彆為(143±21)、(87±13)mmHg(P<0.05);HR在T4和T5分彆為(93±8)、(83±10)次/分(P<0.05).結論 鹽痠右美託咪啶能有效預防全痳拔管時的心血管反應,提高拔管質量.
목적 관찰염산우미탁미정대전마기관발관시심혈관반응적예방작용.방법 전마행위장도수술적환자100례,성별불한,ASAⅡ혹Ⅲ급,년령30세～60세;체중(kg)재표준체중±20%,채용수궤수자표법장환자위2조(매조50례):병박분조(P조)화염산우미탁미정조(D조).술필환자전입마취후회복실,P조파공수주병박분,혈장파농도설정위1 mg/L,D조정주염산유미탁미정부하여유지제량분별위0.5μg/kg(10 min주사완필)、0.5μg·kg-1·h-1,량조균우자주호흡회복시정약.기록술전(T0)、전입마취후회복실즉각(T1)、급약후10 min(T2)、자주호흡회복(T3)、발관시(T4)、발관후10 min(T5)적혈압(BP)、심솔(HR)화해수반응정황.기록호기말마취약농도,자주호흡회복시간、호환정안시간、발관시간、시각모의평분화부작용정황.결과 D조,수축압(SBP)、서장압(DBP)화HR재T4분별위(124±15)、(79±11)、(74±10)mmHg(1 mm Hg=0.133 kPa);P조위(143±21)、(87±13)、(93±8)mm Hg(P<0.05).D조,SBP、DBP화HR재T5분별위(120±14)、(75±8)、(75±9)mm Hg;P조위(128±22)、(80±12)、(83±10)mm Hg(P<0.05).D조,자주호흡회복시간화호환정안시간분별위(4±3)、(4±4)min,P조위(6±5)、(8±5)min(P<0.05).발관시D조발생중도해수3례,P조23례(P<0.05).발관후D조시각모의평분위(3.6±2.0),P조위(5.5±3.1)(P<0.05).여T0비교,P조SBP、DBP재Td분별위(143±21)、(87±13)mmHg(P<0.05);HR재T4화T5분별위(93±8)、(83±10)차/분(P<0.05).결론 염산우미탁미정능유효예방전마발관시적심혈관반응,제고발관질량.
Objective To observe the effects of dexmedetomidine hydrochloride on cardiovascular response to tracheal extubation. Methods One hundred ASA Ⅱ or IE patients regardless of sex aged 30 yr ～60 yr with a standard body weight±20% scheduled for gastrointestinal surgery under general anesthesia were randomly divided into 2 groups (n=50):propofol group (group P) and dexmedetomidine hydrochloride group (group D). Patients were transported into the postanesthetic recovery room after surgery. Patients in group P were maintained with propofol with a plasma target concentration at 1 mg/L. Patients in group D were injected loading dose and maintenance dose of dexmedetomidine hydrochloride at the rate of 0.5 μg/kg (10 in infusion) and 0.5 μg·kg-1·h-1, respectively. All infusions were discontinued when patients of both groups restored spontaneous breathing. BP, HR, and cough response were recorded at preoperative period (T0), immediately transportd into postanesthetic recovery room (T1), 10 mins after administration (T2), spontaneous breathing (T3), extubation (T4), 10 mins after extubation (T5). End -tidal anesthetic concentration, spontaneous breathing time, eyes open time given stimulation, extubation time, visual analog score and side effects were recorded. Results SBP, DBP and HR at T4 were respectively (124±15), (79±11),(74±10) mm Hg(l mm Hg=0.133 kPa) in group D. SBP, DBP and HR at T4 were respectively(143±21 ),(87±13),(93±8) mm Hg(P<0.05). SBP, DBP and HR at T5 were respectively (120± 13.5),(75±8),(75±9) mm Hg in group D. DBP and HR were respectively (128±22), (80±12),(83±10) mm Hg (P<0.05). Spontaneous breathing and eyes open time was (4±3),(4±4) min in group D, which were (6±5),(8±5) min in group P (P<0.05). The cough response was 3 case in group D, which was 23 case in group P (P<0.05).VAS score were (3.6±2.0) in group D, which were(5.5±3.l) in group P(P<0.05). Compared with T0, SBP and DBP at T4 were respectively (143±21),(87±13) mm Hg in group P(P<0.05), HR at T4 and T5 were respectively (93±8) beats/min and (83±10) beats/min in group P (P<0.05). Conclusion Dexmedetomidine (DEX) hydrochloride could efficiently prevent the adverse cardiovascular response to tracheal extubation and improve the quality of extubation.
