CAJ | 학술논문

目的研究右旋美托咪啶(dexmedetomidine,Dex)对听觉诱发电位指数(auditory evoked potential index,AAI)的影响和对气管插管血流动力学的影响. 方法择期手术患者60例(ASA Ⅰ ～Ⅱ级),采用随机数字表法随机分成Dex组(D组)和对照组(C组):D组静脉泵注Dex负荷剂量1μg/kg(20 min泵完)；C组以同样方式泵注生理盐水.泵注完成2 min后诱导插管,记录泵药前(T0)、诱导前(T1)、插管前(T2)、插管后即刻(T3)、插管后3(T4)、5(T5)、10 min (T6)的收缩压(SBP)、平均动脉压(MAP)、舒张压(DBP)、心率(HR)、脉搏氧饱和度(SpO2)和AAI. 结果两组患者术前一般情况基本相同,D组的AAI值在T0和T1时点分别为(62±5)和(35±6)(P＜0.01),下降约53％,而C组的AAI值在泵药前后无明显变化.在插管后即刻D组的SBP、MAP、DBP和HR分别为[(112±18)、(90±19)、(80±19) mm Hg(1 mmHg=0.133 kPa)、(81±14)次/min],与C组[(140±21)、(109±16)、(97±17) mm Hg、(95±10)次/min]比较差异有统计学意义(P＜0.05). 结论Dex可以产生良好的镇静作用,并且能够抑制患者的气管插管血流动力学反应.
목적 연구우선미탁미정(dexmedetomidine,Dex)대은각유발전위지수(auditory evoked potential index,AAI)적영향화대기관삽관혈류동역학적영향. 방법 택기수술환자60례(ASA Ⅰ ～Ⅱ급),채용수궤수자표법수궤분성Dex조(D조)화대조조(C조):D조정맥빙주Dex부하제량1μg/kg(20 min빙완)；C조이동양방식빙주생리염수.빙주완성2 min후유도삽관,기록빙약전(T0)、유도전(T1)、삽관전(T2)、삽관후즉각(T3)、삽관후3(T4)、5(T5)、10 min (T6)적수축압(SBP)、평균동맥압(MAP)、서장압(DBP)、심솔(HR)、맥박양포화도(SpO2)화AAI. 결과량조환자술전일반정황기본상동,D조적AAI치재T0화T1시점분별위(62±5)화(35±6)(P＜0.01),하강약53％,이C조적AAI치재빙약전후무명현변화.재삽관후즉각D조적SBP、MAP、DBP화HR분별위[(112±18)、(90±19)、(80±19) mm Hg(1 mmHg=0.133 kPa)、(81±14)차/min],여C조[(140±21)、(109±16)、(97±17) mm Hg、(95±10)차/min]비교차이유통계학의의(P＜0.05). 결론Dex가이산생량호적진정작용,병차능구억제환자적기관삽관혈류동역학반응.
Objective To study the influence of dexmedetomidine (Dex) on auditory evoked potential index (AAI) and its hemodynamic influence as tracheal intubation. Methods 60 patients were randomized divided into dexmedetomidine group (D group) or control group(C group).Patients were intravenously pumped into Dex 1 μg/kg with in 20 min in D group,the same volume placebo was administered in C group.Tracheal intubation was done 2 min after medication.Systolic blood pressure (SBP),mean arterial pressure(MAP),diastolic blood pressure(DBP),heart rates(HR),pulse oxygen saturation(SpO2) and AAI were recorded at the following time points (before medication,before induction,before intubation,the time after intubation,3 min after intubation,5 min after intubation and 10 min after intubation). Results Before medication,the general conditions have no difference in two groups.The values of AAI before medication and before induction were (62±5) and (35±6)(P＜0.05) respectively,decreased by 53％,and there were no difference in C group.The SBP,MAP,DBP and HR at the time after intubation in D group were (112±18),(90±19),(80±19) mm Hg(1 mmHg=0.133 kPa) and (81±14) beat/min respectively,while in C group were (140±21),(109±16),(97±17) mm Hg,(95±10) beat/min respectively,there were significant difference between the two groups(P＜0.05). Conclusions Dex has good sedative effects before surgery,and it can also depress the stress responses of tracheal intubation effectively.