CAJ | 학술논문

目的：研究右美托咪定（dexmedtomidine，DEX)对高血压患者手术麻醉诱导过程中循环功能的影响。方法选择40例行脊柱手术麻醉的高血压患者， ASAⅡ-Ⅲ级，随机分为两组（n=40）：右美托咪定组(D组,n=20)和生理盐水对照组(N组，n=20)，对照组按常规诱导麻醉,右美托咪定组在麻醉诱导前，使用右美托咪定0.5μg/kg在10分钟内泵入，接着持续用0.5μg/kg/h，记录基础值(T0)、生理盐水对照和右美托咪啶注射后(T1)、插管前(T2)及气管内插管后1min(T3)，3min(T4)，5min(T5)时的血压和心率。结果 N组MAP、SAP及DAP在插管前(T2)与基础值(T0)相比下降、在气管插管后1min(T3)、3min (T4)，与基础值相比都升高，差异有统计学意义(P<0．05)。D组血压波动不明显，两组间比较差异有统计学意义。试验组的心率，在右美托咪定注射后与对照组相比明显降低，有统计学差异(P<0．05)。结论右美托咪定可以有效的抑制由于麻醉诱导和气管插管所导致的心血管反应，稳定循环功能。
목적：연구우미탁미정（dexmedtomidine，DEX)대고혈압환자수술마취유도과정중순배공능적영향。방법선택40례행척주수술마취적고혈압환자， ASAⅡ-Ⅲ급，수궤분위량조（n=40）：우미탁미정조(D조,n=20)화생리염수대조조(N조，n=20)，대조조안상규유도마취,우미탁미정조재마취유도전，사용우미탁미정0.5μg/kg재10분종내빙입，접착지속용0.5μg/kg/h，기록기출치(T0)、생리염수대조화우미탁미정주사후(T1)、삽관전(T2)급기관내삽관후1min(T3)，3min(T4)，5min(T5)시적혈압화심솔。결과 N조MAP、SAP급DAP재삽관전(T2)여기출치(T0)상비하강、재기관삽관후1min(T3)、3min (T4)，여기출치상비도승고，차이유통계학의의(P<0．05)。D조혈압파동불명현，량조간비교차이유통계학의의。시험조적심솔，재우미탁미정주사후여대조조상비명현강저，유통계학차이(P<0．05)。결론우미탁미정가이유효적억제유우마취유도화기관삽관소도치적심혈관반응，은정순배공능。
Objective: To investigate the effects of demedetomidine premedication on the circulation in patients with hypertension during anesthetic induction and tracheal intubation. Methods: Forty patients with hypertension scheduled for spinal surgery were enrol ed in this study. Patients were randomized into two group (n=20 each):group C=control; group D=dexmedetomidine. Dexmedetomidine (0.5ug/kg) were administered to patients in group D by a infusion pump 10min prior to anesthetic induction. While patients in group C received the same volume normal saline. The infusion lasted 10 min. BP( Blood pressure)HR(heart rate)were respectively recorded at the fol owing time points, before infusion of dexmedetomidine (T0), immediately before tracheal intubation(Tl),1, 3, 5 min after tracheal intubation(T2-5).Results: Compared with T0,In group N,BP were significantly decreased at T1 then increased at T3 and T4(P<0.05) .These variables had no significant change in group D. Statistical y significant differences were found between the two groups(P<0.05).The level of HR was significantly lower at Tl-5 than that at T0 in group D, Statistical y significant differences were found between the two groups(P<0.05). Conclusion: Dexmedetomidine premedication can safely and effectively al eviate the cardiovascular response and keep the stability of circulation in patients with hypertension during anesthetic induction and tracheal intubation.