中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
1期
69-71
,共3页
王香%顾达民%张科%葛志军
王香%顧達民%張科%葛誌軍
왕향%고체민%장과%갈지군
右美托咪定%腹腔镜下胆囊切除术%脑电双频指数
右美託咪定%腹腔鏡下膽囊切除術%腦電雙頻指數
우미탁미정%복강경하담낭절제술%뇌전쌍빈지수
Dexmedetomidine%Laparoscopic cholecystectomy%Bispectral index
目的 观察全麻诱导前给予右美托咪定对于腹腔镜下胆囊切除术(LC)患者血流动力学的影响.方法 40例ASAI ～ Ⅱ级择期行LC的患者,完全随机分为右美托咪定组和生理盐水组,各20例.右美托咪定组于全麻诱导前静脉泵注右美托咪定1 μg/kg,泵注时间为10 min,生理盐水组以同样的速率静脉泵注相同容量的生理盐水,2组全麻诱导均使用咪达唑仑0.05 mg/kg、丙泊酚1mg/kg、芬太尼4μg/kg、顺苯磺酸阿曲库铵0.2 mg/kg,术中以七氟醚吸入维持麻醉,观察记录静脉泵注开始前(T0)、静脉泵注10 min后(T1)、气管插管后即刻(T2)、手术结束时(T3)、气管拔管即刻(T4)、气管拔管后5 min(T5)气管拔管后10 min(T6)7个时间点的脑电双频指数(BIS)、MAP、HR,并记录苏醒时间、拔管时间,拔管后进行Ramsay镇静评分,观察有无呛咳、恶心、呕吐等不良反应.结果 有美托咪定组患者行气管插管、气管拔管时血流动力学更平稳(P＜0.05).右美托咪定组苏醒时间(19±5) min,拔管时间(22±4) min,生理盐水组分别为(18±4) min、(22 ±4) min,2组比较差异均无统计学意义(均P＞0.05).术后右美托咪定组无躁动、寒战、恶心、呕吐发生,生理盐水组有1例躁动,2例寒战.结论 术前预给右美托咪定可以使腹腔镜下胆囊切除术患者气管插管和拔管期间血流动力学更平稳,不影响麻醉苏醒和拔管时间,术后躁动、寒战、恶心、呕吐发生率更低.
目的 觀察全痳誘導前給予右美託咪定對于腹腔鏡下膽囊切除術(LC)患者血流動力學的影響.方法 40例ASAI ～ Ⅱ級擇期行LC的患者,完全隨機分為右美託咪定組和生理鹽水組,各20例.右美託咪定組于全痳誘導前靜脈泵註右美託咪定1 μg/kg,泵註時間為10 min,生理鹽水組以同樣的速率靜脈泵註相同容量的生理鹽水,2組全痳誘導均使用咪達唑崙0.05 mg/kg、丙泊酚1mg/kg、芬太尼4μg/kg、順苯磺痠阿麯庫銨0.2 mg/kg,術中以七氟醚吸入維持痳醉,觀察記錄靜脈泵註開始前(T0)、靜脈泵註10 min後(T1)、氣管插管後即刻(T2)、手術結束時(T3)、氣管拔管即刻(T4)、氣管拔管後5 min(T5)氣管拔管後10 min(T6)7箇時間點的腦電雙頻指數(BIS)、MAP、HR,併記錄囌醒時間、拔管時間,拔管後進行Ramsay鎮靜評分,觀察有無嗆咳、噁心、嘔吐等不良反應.結果 有美託咪定組患者行氣管插管、氣管拔管時血流動力學更平穩(P＜0.05).右美託咪定組囌醒時間(19±5) min,拔管時間(22±4) min,生理鹽水組分彆為(18±4) min、(22 ±4) min,2組比較差異均無統計學意義(均P＞0.05).術後右美託咪定組無躁動、寒戰、噁心、嘔吐髮生,生理鹽水組有1例躁動,2例寒戰.結論 術前預給右美託咪定可以使腹腔鏡下膽囊切除術患者氣管插管和拔管期間血流動力學更平穩,不影響痳醉囌醒和拔管時間,術後躁動、寒戰、噁心、嘔吐髮生率更低.
목적 관찰전마유도전급여우미탁미정대우복강경하담낭절제술(LC)환자혈류동역학적영향.방법 40례ASAI ～ Ⅱ급택기행LC적환자,완전수궤분위우미탁미정조화생리염수조,각20례.우미탁미정조우전마유도전정맥빙주우미탁미정1 μg/kg,빙주시간위10 min,생리염수조이동양적속솔정맥빙주상동용량적생리염수,2조전마유도균사용미체서륜0.05 mg/kg、병박분1mg/kg、분태니4μg/kg、순분광산아곡고안0.2 mg/kg,술중이칠불미흡입유지마취,관찰기록정맥빙주개시전(T0)、정맥빙주10 min후(T1)、기관삽관후즉각(T2)、수술결속시(T3)、기관발관즉각(T4)、기관발관후5 min(T5)기관발관후10 min(T6)7개시간점적뇌전쌍빈지수(BIS)、MAP、HR,병기록소성시간、발관시간,발관후진행Ramsay진정평분,관찰유무창해、악심、구토등불량반응.결과 유미탁미정조환자행기관삽관、기관발관시혈류동역학경평은(P＜0.05).우미탁미정조소성시간(19±5) min,발관시간(22±4) min,생리염수조분별위(18±4) min、(22 ±4) min,2조비교차이균무통계학의의(균P＞0.05).술후우미탁미정조무조동、한전、악심、구토발생,생리염수조유1례조동,2례한전.결론 술전예급우미탁미정가이사복강경하담낭절제술환자기관삽관화발관기간혈류동역학경평은,불영향마취소성화발관시간,술후조동、한전、악심、구토발생솔경저.
Objective To study the effect of dexmedetomidine before general anesthesia on hemodynamics in old patients undergoing laparoscopic cholecystectomy.Methods Forty American society of anesthesiologists (ASA) Ⅰ-Ⅱ patients undergoing laparoscopic cholecystectomy were randomly divided into dexmedetomidine group (n =20) and physiological saline group (n =20):dexmedetomidine group had dexmedetomidine and physiological saline group had saline; two groups used same drugs for induction of general anesthesia.Observation timepoints included:before pump injection (T0),after pump 10 min (T1),after tracheal intubation (T2),after the end of the surgery (T3),tracheal drawing tube immediate (T4),5 min after tracheal drawing tube (T5),after tracheal drawing tube 10 min (T6); bispectral Index (BIS),MAP,HR,waking time (T1),tracheal drawing tube time (T2),and adverse reactions such as choke cough,nausea and vomiting were all observed.Results Hemodynamic of tracheal intubation and tracheal extubation in dexmedetomidine group was stable (P ＜ 0.05).The recovery time and extubation time in dexmedetomidine group and saline group were (19 ± 5)min,(22 ± 4) min and (18 ± 4) min,(22 ± 4) min,respectively ; the difference were not statistically significant (P ＞ 0.05).No postoperative agitation,chills,nausea and vomiting occurred in dexmedetomidine group.Saline group had 1 case of restlessness and 2 cases of shivering.Conclusion Preoperative dexmedetomidine may make hemodynamics more smoothly in patients with laparoscopic cholecystectomy during tracheal intubation and extubation without affecting the anesthesia recovery and extubation time,showing a low rate of postoperative agitation,chills,nausea and vomiting.
