CAJ | 학술논문

目的观察不同浓度右美托咪定对罗库溴铵肌松起效时间及临床时效的影响.方法择期全麻下行乳腺癌改良性根治术患者60例,年龄26～55岁,随机分为四组,每组15例.A组(对照组):麻醉诱导前10 min内匀速输注生理盐水(NS)0.25 ml/kg;B、C、D组分别以右美托咪定初始剂量0.3、0.6、1.0 μg/kg麻醉诱导前10 min内匀速输注完,麻醉期间以0.3、0.6、1.0 μg/(g·h)持续泵注至手术结束.患者入室后均在多功能生命体征监测仪下监测血压(BP)、心率(HR)、血氧饱和度(SpO2)、心电图(ECG)、气管插管后监测呼气末二氧化碳(EtCO2),记录To和T25的时间及血流动力学的变化.结果 To时间各组差异无统计学意义(P＞0.05),但C组和D组中T25时间[(48 ±6) min和(51 ±6)min]与A组[(40±6)min]比较差异有统计学意义(P＜0.05).B、C、D组用不同浓度的右美托咪定后与A组相比,C和D组给药后5 min血压明显下降[(88.76 ±7.06) mmHg,(87.89±6.95) mmHg,P＜0.05],B组和C组诱导前心率[(60.80±7.11)次/min,(63.31 ±5.78)次/min]与A组比较明显下降(P＜0.05),D组心率在给药后5 min、诱导前及给药后30 min明显下降[(66.40±9.49)次/min,(60.52 ±7.45)次/min,(61.32±7.11)次/min,P＜0.05].结论不同浓度右美托咪定对罗库溴铵的起效时间没有影响,但右美托咪定增加到一定浓度时能够增强罗库溴铵的临床时效.不同浓度右美托咪对围手术期的血压及心率有影响.
목적 관찰불동농도우미탁미정대라고추안기송기효시간급림상시효적영향.방법 택기전마하행유선암개량성근치술환자60례,년령26～55세,수궤분위사조,매조15례.A조(대조조):마취유도전10 min내균속수주생리염수(NS)0.25 ml/kg;B、C、D조분별이우미탁미정초시제량0.3、0.6、1.0 μg/kg마취유도전10 min내균속수주완,마취기간이0.3、0.6、1.0 μg/(g·h)지속빙주지수술결속.환자입실후균재다공능생명체정감측의하감측혈압(BP)、심솔(HR)、혈양포화도(SpO2)、심전도(ECG)、기관삽관후감측호기말이양화탄(EtCO2),기록To화T25적시간급혈류동역학적변화.결과 To시간각조차이무통계학의의(P＞0.05),단C조화D조중T25시간[(48 ±6) min화(51 ±6)min]여A조[(40±6)min]비교차이유통계학의의(P＜0.05).B、C、D조용불동농도적우미탁미정후여A조상비,C화D조급약후5 min혈압명현하강[(88.76 ±7.06) mmHg,(87.89±6.95) mmHg,P＜0.05],B조화C조유도전심솔[(60.80±7.11)차/min,(63.31 ±5.78)차/min]여A조비교명현하강(P＜0.05),D조심솔재급약후5 min、유도전급급약후30 min명현하강[(66.40±9.49)차/min,(60.52 ±7.45)차/min,(61.32±7.11)차/min,P＜0.05].결론 불동농도우미탁미정대라고추안적기효시간몰유영향,단우미탁미정증가도일정농도시능구증강라고추안적림상시효.불동농도우미탁미대위수술기적혈압급심솔유영향.
Objective To investigate effects of different concentrations of dexmedetomidine on onset time and clinical time-effect of rocuronium in the processes of the total intravenous anesthesia.Methods Sixty patients with elective anesthesia breast modified radical mastectomy,aged 26 to 55 years,were randomly divided into four groups of 15 patients.Group A (control group):uniform within 10 min before induction of anesthesia saline infusion (NS ; 0.25 ml/kg) ; group B:dexmedetomidine given initial dose 0.3 μg/kg uniform within 10 min before induction of anesthesia infusion finished,anesthesia period 0.3 μg/(g · h) continuous infusion until the end of surgery; group C:dexmedetomidine given initial dose 0.6 μg/kg uniform within 10 min before anesthesia infusion finished,during anesthesia with continuous infusion 0.6 μg/'(kg · h) until the end of surgery ; and group D:dexmedetomidine given initial dose 1 μg/kg uniform within 10 min before anesthesia infusion finished,during anesthesia to 1 μg/(kg · h) continuous infusion to the end of surgery.Patients after the burglary were under multi-monitor vital signs monitoring blood pressure (BP),heart rate (HR),oxygen saturation (SPO2),electrocardiogram (ECG),and after intubation monitoring end-tidal carbon dioxide (EtCO2),recording time T0 and T25.Results No significant difference was found at the T0 time in each group.However,the T25 time (48 ± 6) min in group C and (51 ±6) min in group D was significant longer than that (40 ±6)min in group A (P ＜0.05).The mean artery pressure(MAP) of group C and D [(88.76 ± 7.06)mmHg,(87.89 ± 6.95)mmHg] were significantly lower than group A after dexmedetomidine infusion 5 min later(P ＜ 0.05); The HR of groups B and C [(60.80 ± 7.11)bpm,(63.31 ± 5.78)bpm] were significantly lower than group A before induction (P ＜ 0.05).The HR of group D was significantly lower than group A before induction and after infusion 5 and 30 min later[(66.40 ± 9.49) bpm,(60.52 ± 7.45) bpm,(61.32 ± 7.11) bpm,P ＜ 0.05].Conclusions Under the status of total intravenous anesthesia,different concentrations of dexmedetomidine did not affect the onset time of rocuronium,but dexmedetomidine given up to a certain concentration could enhance the clinical time-effect of rocuronium.