CAJ | 학술논문

目的：采用右美托咪啶辅助喉罩用于颅内动脉瘤栓塞术的全身麻醉，观察患者血流动力学的变化。方法80例行颅内动脉瘤栓塞术的患者，随机分为四组（n=20），A组：采用喉罩全麻，麻醉诱导前10 min静脉泵注右美托咪啶1.0μg/kg；B组：采用喉罩全麻，与A组用同样方式输注等量生理盐水；C组：采用气管插管全麻，与A组相同方法应用右美托咪啶；D组：气管插管全麻，与B组用同样方法应用生理盐水。观察并记录4组患者不同时点：诱导前（T0）、喉罩（气管导管）置入即刻（T1）、拔管即刻（T2）、拔管后5 min（T3）的平均动脉压（MAP）和心率（HR）。结果4组患者在麻醉诱导前的MAP、HR差异均无统计学意义（P>0.05）。与T 0比较，A组在T 1、T 2、T 3的MAP、HR无明显变化（P>0.05）；B、C、D组在T 1、T 2、T 3的MAP、HR明显升高（P<0.05）。与A组比较，B、C、D组在T1、T2、T3的MAP、HR明显升高（P<0.05）。结论右美托咪啶辅助喉罩用于颅内动脉瘤栓塞术的全身麻醉有助于血流动力学稳定，可增加患者的安全性。
목적：채용우미탁미정보조후조용우로내동맥류전새술적전신마취，관찰환자혈류동역학적변화。방법80례행로내동맥류전새술적환자，수궤분위사조（n=20），A조：채용후조전마，마취유도전10 min정맥빙주우미탁미정1.0μg/kg；B조：채용후조전마，여A조용동양방식수주등량생리염수；C조：채용기관삽관전마，여A조상동방법응용우미탁미정；D조：기관삽관전마，여B조용동양방법응용생리염수。관찰병기록4조환자불동시점：유도전（T0）、후조（기관도관）치입즉각（T1）、발관즉각（T2）、발관후5 min（T3）적평균동맥압（MAP）화심솔（HR）。결과4조환자재마취유도전적MAP、HR차이균무통계학의의（P>0.05）。여T 0비교，A조재T 1、T 2、T 3적MAP、HR무명현변화（P>0.05）；B、C、D조재T 1、T 2、T 3적MAP、HR명현승고（P<0.05）。여A조비교，B、C、D조재T1、T2、T3적MAP、HR명현승고（P<0.05）。결론우미탁미정보조후조용우로내동맥류전새술적전신마취유조우혈류동역학은정，가증가환자적안전성。
Objective To observe the hemodynamic changes affected by combined application of dexmedetomidine and laryngeal mask airway (LMA) during general anesthesia in the interventional embolization of intracranial aneurysm.Methods 80 cases of patients with intracranial aneurysm were randomly divided into 4 groups (n=20). Group A: patients were conducted of LMA insertion with dexmedetomidine infusion (1.0μg/kg) 10min before anesthesia induction. Group B: patients were conducted of LMA insertion with equivalent saline infusion 10min before anesthesia induction. Group C: patients were conducted of endotracheal tube (ETT) intubation, and dexmedetomidine was infused with the same method in group A. Group D: patients were conducted of endotracheal tube intubation, and saline was infused with the same method in group B. Mean blood pressure (MAP) and heart rate (HR) were recorded and analyzed at four time points: before anesthesia induction (T0), LMA (ETT) insertion (T1), LMA (ETT) removal (T2), 5min after LMA (ETT) removal (T3).Results Before induction of anesthesia, there was no significant difference of MAP and HR between 4 groups (P>0.05). Compared withthe MAP and HR at T0, the MAP and HR at T1, T2, and T3 showed no significant difference in group A (P>0.05), while the MAP and HR at T1, T2, and T3 all increased significantly in group B, group C and group D (P<0.05). Compared with group A, the MAP and HR at T1, T2, and T3 all increased significantly in group B, group C and group D (P<0.05).Conclusion During general anesthesia in the interventional embolization of intracranial aneurysms, combined application of dexmedetomidine and LMA could help hemodynamic stability so as to increase the safety of patients.