CAJ | 학술논문

目的：盐酸右美托咪定对硬膜外复合全麻下妇科手术全麻诱导期血流动力学的影响。方法选择本院择期妇科全子宫切除术40例（ASAⅠ～Ⅱ级），随机分为盐酸右美托咪定组（D 组）20例和丙泊酚组（P 组）20例，D 组行连续硬膜外麻醉，0．5μg /（kg·h）持续输注，待麻醉平面确定后全麻诱导气管插管；丙 P 组除不给予盐酸右美托咪定，其他各项与 D 组相同。记录入室后（T1），硬膜外麻醉平面确定后（T2），全麻诱导前（T3），气管插管前即刻（T4），气管插管后即刻（T5）和手术开始时（T6）时患者的收缩压（SBP），舒张压（DBP），平均动脉压（MAP），心率（HR）及氧饱和度（SpO2）。结果 T1时间点2组各指标均无差别（P ＞0．05）。D 组与 P 组比较，其余各时间点的 HR 均低于 P 组（P ＜0．05），T5和 T6时间点 SBP、DBP、MAP 低于同时点 P 组（P ＜0．05），T2、T3和 T4 SBP、DBP、MAP 高于同时点 P 组（P ＜0．05）。结论盐酸右美托咪定应用于连续硬膜外复合全麻患者，在全麻诱导期患者血流动力学更加稳定。
목적：염산우미탁미정대경막외복합전마하부과수술전마유도기혈류동역학적영향。방법선택본원택기부과전자궁절제술40례（ASAⅠ～Ⅱ급），수궤분위염산우미탁미정조（D 조）20례화병박분조（P 조）20례，D 조행련속경막외마취，0．5μg /（kg·h）지속수주，대마취평면학정후전마유도기관삽관；병 P 조제불급여염산우미탁미정，기타각항여 D 조상동。기록입실후（T1），경막외마취평면학정후（T2），전마유도전（T3），기관삽관전즉각（T4），기관삽관후즉각（T5）화수술개시시（T6）시환자적수축압（SBP），서장압（DBP），평균동맥압（MAP），심솔（HR）급양포화도（SpO2）。결과 T1시간점2조각지표균무차별（P ＞0．05）。D 조여 P 조비교，기여각시간점적 HR 균저우 P 조（P ＜0．05），T5화 T6시간점 SBP、DBP、MAP 저우동시점 P 조（P ＜0．05），T2、T3화 T4 SBP、DBP、MAP 고우동시점 P 조（P ＜0．05）。결론염산우미탁미정응용우련속경막외복합전마환자，재전마유도기환자혈류동역학경가은정。
Objective To observe the effect of Dexmedetomidine (DEX)on induction peri-od of hemodynamics in patients undergoing general anesthesia combined with epidural block.Meth-ods A total of 40 hysterectomy patients in optional period (ASA Ⅰ~Ⅱ)were randomly divided into Dexmedetomidine group(Group D)and Propofol group(P group).Group D received continuous epidural anesthesia with infusion of DEX 0.5 μg /(kg·h)and endotracheal intubation was applied after general anesthesia.Group P was given the same therapy with group D except dexmedetomi-dine.HR,SBP,DBP and MAP of the hemodynamic index were recorded at the time of entering the operation room(T1),after the determination of epidural plane(T2),pre-intubation(T3),intu-bation(T4),immediately after trachea intubation(T4),and the beginning of operation(T4).Results The difference was not statistically significant in the index between the two groups at T1 .HR of group D was lower than that in group P at all-time points(P <0.05).SBP,DBP and MAP of group D were higher than group P at T2,T3 and T4(P <0.05).SBP,DBP,MAP of group D were lower than group P at T5 and T6(P <0.05).SBP、DBP and MAP in group D at T2、T3 and T4 were higher than that in the group P (P <0.05).Conclusion Dexmedetomidine can offer a stable hemo-dynamics in the patients with general anesthesia combined with epidural block.