贵阳医学院学报
貴暘醫學院學報
귀양의학원학보
JOURNAL OF GUIYANG MEDICAL COLLEGE
2015年
3期
294-296
,共3页
咸淑悦%周妙苗%马敏%王成夭
鹹淑悅%週妙苗%馬敏%王成夭
함숙열%주묘묘%마민%왕성요
右美托咪定%七氟醚%脑电双频指数%血流动力学%插管法,气管内
右美託咪定%七氟醚%腦電雙頻指數%血流動力學%插管法,氣管內
우미탁미정%칠불미%뇌전쌍빈지수%혈류동역학%삽관법,기관내
dexmedetomidine%sevoflurane%bispectral index%hemodynamic%intubation,intra tracheal
目的：观察右美托咪定对七氟醚诱导气管插管时血流动力学及镇静深度的影响。方法：择期全麻下行耳鼻喉手术患者36例，ASA分级Ⅰ~Ⅱ级，随机均分为对照组（ A组）、高剂量芬太尼组（ B组）、右美托咪定组（ C组），A、B组诱导时分别给予芬太尼2μg/kg和4μg/kg，C组麻醉诱导前15 min内静脉泵注右美托咪定1.0μg/kg，诱导时给予芬太尼2μg/kg；3组均给予七氟醚“潮气量法”诱导，记录3组患者给药前（ T0）、开始吸入七氟醚即刻（ T1）、气管插管前即刻（ T2）、气管插管后即刻（ T3）的收缩压（ SBP）、舒张压（ DBP）、心率（ HR）、脑电双频指数（ BIS）并分析。结果：3组患者T0时点基础BIS、SBP、DBP及HR比较；差异无统计学意义（ P>0.05）；T1与T0时点比较，C组SBP、HR及BIS值显著低于A、B两组，T2时点C组患者的SBP 显著高于A、B两组，差异有统计学意义（ P<0.05）；T3时点C组患者的SBP、DBP及HR显著低于A组，BIS低于A、B两组，差异有统计学意义（ P<0.05）。结论：七氟醚诱导插管时右美托咪定在降低BIS的同时可维持稳定的血流动力学。
目的：觀察右美託咪定對七氟醚誘導氣管插管時血流動力學及鎮靜深度的影響。方法：擇期全痳下行耳鼻喉手術患者36例，ASA分級Ⅰ~Ⅱ級，隨機均分為對照組（ A組）、高劑量芬太尼組（ B組）、右美託咪定組（ C組），A、B組誘導時分彆給予芬太尼2μg/kg和4μg/kg，C組痳醉誘導前15 min內靜脈泵註右美託咪定1.0μg/kg，誘導時給予芬太尼2μg/kg；3組均給予七氟醚“潮氣量法”誘導，記錄3組患者給藥前（ T0）、開始吸入七氟醚即刻（ T1）、氣管插管前即刻（ T2）、氣管插管後即刻（ T3）的收縮壓（ SBP）、舒張壓（ DBP）、心率（ HR）、腦電雙頻指數（ BIS）併分析。結果：3組患者T0時點基礎BIS、SBP、DBP及HR比較；差異無統計學意義（ P>0.05）；T1與T0時點比較，C組SBP、HR及BIS值顯著低于A、B兩組，T2時點C組患者的SBP 顯著高于A、B兩組，差異有統計學意義（ P<0.05）；T3時點C組患者的SBP、DBP及HR顯著低于A組，BIS低于A、B兩組，差異有統計學意義（ P<0.05）。結論：七氟醚誘導插管時右美託咪定在降低BIS的同時可維持穩定的血流動力學。
목적：관찰우미탁미정대칠불미유도기관삽관시혈류동역학급진정심도적영향。방법：택기전마하행이비후수술환자36례，ASA분급Ⅰ~Ⅱ급，수궤균분위대조조（ A조）、고제량분태니조（ B조）、우미탁미정조（ C조），A、B조유도시분별급여분태니2μg/kg화4μg/kg，C조마취유도전15 min내정맥빙주우미탁미정1.0μg/kg，유도시급여분태니2μg/kg；3조균급여칠불미“조기량법”유도，기록3조환자급약전（ T0）、개시흡입칠불미즉각（ T1）、기관삽관전즉각（ T2）、기관삽관후즉각（ T3）적수축압（ SBP）、서장압（ DBP）、심솔（ HR）、뇌전쌍빈지수（ BIS）병분석。결과：3조환자T0시점기출BIS、SBP、DBP급HR비교；차이무통계학의의（ P>0.05）；T1여T0시점비교，C조SBP、HR급BIS치현저저우A、B량조，T2시점C조환자적SBP 현저고우A、B량조，차이유통계학의의（ P<0.05）；T3시점C조환자적SBP、DBP급HR현저저우A조，BIS저우A、B량조，차이유통계학의의（ P<0.05）。결론：칠불미유도삽관시우미탁미정재강저BIS적동시가유지은정적혈류동역학。
Objective:To observe the effect of dexmedetomidine on the hemodynamic and BIS during anesthetic induction with sevoflurane and tracheal intubation. Methods:Thirty-six American Society of Anesthesiology( ASA)physical status I and II patients,undergoing selective otorhinolaryngologic oper-ation under general anesthesia were randomly divided into three groups. Group A received saline solu-tion 15 minutes before anesthetic induction and fentanyl 2 μg/kg during induction;Group B received saline solution 15 minutes before anesthetic induction and fentanyl 4 μg/kg during induction;Group C received dexmedetomidine at an initial dose of 1. 0 μg/kg 15 minutes before anesthetic induction and fentanyl 2 μg/kg during induction. Patients of the three groups all received tidal breathing induction with sevoflurane. The hemodynamic parameters:systolic blood pressure( SBP),diastolic blood pres-sure( DBP),heart rate( HR)and BIS were recorded at four time points:the moment before the use of saline solution or dexmedetomidine( T0 ),the moment before sevoflurane induction( T1 ),the moment before intubation( T2 )and the moment after intubation( T3 ). Results:Compared with T0 ,SBP and HR of Group C at T1 were significantly lower than those of Group A and Group B(P <0. 05);SBP of Group C was siginificantly higher than that of Group A and Group B at T2(P<0. 05);At T3,SBP, DBP and HR of Group C were significantly lower than those of Group A(P <0. 05)while BIS of Group C was lower than that of Group A and Group B( P<0 . 05 ). Conclusion:Dexmedetomidine can reduce BIS value and make the hemodynamic stable during the induction with sevoflurane and tra-cheal intubation.
