右美托咪定与丙泊酚对老年全身麻醉手术患者血流动力学影响的研究(1)
摘 要 目的：探讨右美托咪定(dexmedetomidine，DEX)与丙泊酚对老年全身麻醉手术患者血流动力学的影响。方法：选取我院2012年7月-2014年2月期间确诊须行上腹部手术治疗的老年高血压患者74例，随机分为DEX组和对照组，对照组给予常规1～2 mg/kg丙泊酚麻醉，DEX组给予0.4 μg/kg DEX和1～2 mg/kg丙泊酚麻醉，对比两组患者血流动力学及躁动发生情况。结果：DEX组患者注射DEX后各时点平均动脉压均明显低于对照组患者，差异有统计学意义(P<0.05)；DEX组患者注射DEX后各时点心率均明显低于对照组患者，差异有统计学意义(P<0.05)；DEX组患者躁动发生率为16.21%，对照组患者躁动发生率为27.03%，差异有统计学意义(P<0.05)。结论：DEX配合丙泊酚能有效改善老年全身麻醉手术患者血流动力学波动，减少老年患者术后躁动的发生，减轻麻醉不良反应，值得临床进一步推广。
关键词 右美托咪定 丙泊酚 全身麻醉 血流动力学
, 百拇医药
中图分类号：R614.24； R971.3 文献标识码：B 文章编号：1006-1533(2014)19-0032-03
Study on the effect of dexmedetomidine and propofol on hemodynamics
in the elderly patients with general anesthesia*
LI Jianping**， CHEN Senling， CAI Qin， ZOU Yuan
(The First People’s Hospital of Nankang District of Ganzhou City， Ganzhou 341400， China)
ABSTRACT Objective： To investigate the effect of dexmedetomidine (DEX) and propofol on hemodynamics in the elderly patients with general anesthesia. Methods： Seventy-four cases of the elderly patients with hypertension， who were diagnosed to undergo upper abdominal operation in our hospital from July， 2012 to February， 2014， were randomly divided into a DEX group and a control group， in which 1～2 mg/kg propofol was given as a conventional anesthesia in the control group while 0.4 μg/kg DEX in the DEX group besides 1～2 mg/kg of propofol. The restlessness and hemodynamic change in patients were compared between two groups. Results： The mean arterial pressure at different time points after DEX injection in the DEX group was significantly lower than that of the control group (P<0.05)， and the incidence of restlessness was 16.21% in the DEX group and 27.03% in the control group (P<0.05). Conclusion： Hemodynamic fluctuations in the elderly patients with general anesthesia can be effectively improved when DEX combined with propofol was given， which can reduce the incidence of postoperative restlessness and anesthetic adverse reactions and is worthy of further clinical promotion.
, http://www.100md.com
KEY WORDS dexmedetomidine； propofol； anesthesia； hemodynamics
临床上，许多疾病进行手术治疗时须行全身麻醉，以消除患者手术过程中的剧烈疼痛。老年人新陈代谢功能衰退较为明显，手术治疗后易出现各种不良反应，故治疗过程中会给予麻醉诱导，以降低患者的痛苦和术后不良反应的发生[1]。在给予老年患者麻醉治疗后，在苏醒期易并发躁动，降低治疗效果[2]。右美托咪定(dexmedetomidine，DEX)具有调控和改善机体血流动力学波动的作用，可有效降低麻醉引起的苏醒期躁动并发症的发生。为了提高老年心脑血管疾病的麻醉效果，我院对老年患者全身麻醉时给予DEX，取得了较好的效果，现报道如下。
资料与方法
一般资料
选取74例我院2012年7月-2014年2月期间确诊须行腹部手术治疗的老年高血压患者，随机分为DEX组和对照组各37例。DEX组：男21例，女16例，年龄57～78岁，平均年龄(67.45±12.64)岁， 依据美国心脏协会/美国卒中协会(AHA/ASA)分级标准，Ⅰ级11例，Ⅱ级18例，Ⅲ级8例。对照组：男22例，女15例，年龄59～81岁，平均年龄(70.16±13.45)岁，Ⅰ级13例，Ⅱ级17例，Ⅲ级7例。两组患者在性别、年龄、AHA/ASA分级等一般资料上差异无统计学意义(P>0.05)，一般资料具有可比性。两组患者均无心、肝、肾严重疾病史，无精神障碍、脑梗死、颅脑外伤史，所有患者均签署知情同意书且经院伦理委员会批准同意。, http://www.100md.com(李建平 陈森林 蔡青 邹渊)
关键词 右美托咪定 丙泊酚 全身麻醉 血流动力学
, 百拇医药
中图分类号：R614.24； R971.3 文献标识码：B 文章编号：1006-1533(2014)19-0032-03
Study on the effect of dexmedetomidine and propofol on hemodynamics
in the elderly patients with general anesthesia*
LI Jianping**， CHEN Senling， CAI Qin， ZOU Yuan
(The First People’s Hospital of Nankang District of Ganzhou City， Ganzhou 341400， China)
ABSTRACT Objective： To investigate the effect of dexmedetomidine (DEX) and propofol on hemodynamics in the elderly patients with general anesthesia. Methods： Seventy-four cases of the elderly patients with hypertension， who were diagnosed to undergo upper abdominal operation in our hospital from July， 2012 to February， 2014， were randomly divided into a DEX group and a control group， in which 1～2 mg/kg propofol was given as a conventional anesthesia in the control group while 0.4 μg/kg DEX in the DEX group besides 1～2 mg/kg of propofol. The restlessness and hemodynamic change in patients were compared between two groups. Results： The mean arterial pressure at different time points after DEX injection in the DEX group was significantly lower than that of the control group (P<0.05)， and the incidence of restlessness was 16.21% in the DEX group and 27.03% in the control group (P<0.05). Conclusion： Hemodynamic fluctuations in the elderly patients with general anesthesia can be effectively improved when DEX combined with propofol was given， which can reduce the incidence of postoperative restlessness and anesthetic adverse reactions and is worthy of further clinical promotion.
, http://www.100md.com
KEY WORDS dexmedetomidine； propofol； anesthesia； hemodynamics
临床上，许多疾病进行手术治疗时须行全身麻醉，以消除患者手术过程中的剧烈疼痛。老年人新陈代谢功能衰退较为明显，手术治疗后易出现各种不良反应，故治疗过程中会给予麻醉诱导，以降低患者的痛苦和术后不良反应的发生[1]。在给予老年患者麻醉治疗后，在苏醒期易并发躁动，降低治疗效果[2]。右美托咪定(dexmedetomidine，DEX)具有调控和改善机体血流动力学波动的作用，可有效降低麻醉引起的苏醒期躁动并发症的发生。为了提高老年心脑血管疾病的麻醉效果，我院对老年患者全身麻醉时给予DEX，取得了较好的效果，现报道如下。
资料与方法
一般资料
选取74例我院2012年7月-2014年2月期间确诊须行腹部手术治疗的老年高血压患者，随机分为DEX组和对照组各37例。DEX组：男21例，女16例，年龄57～78岁，平均年龄(67.45±12.64)岁， 依据美国心脏协会/美国卒中协会(AHA/ASA)分级标准，Ⅰ级11例，Ⅱ级18例，Ⅲ级8例。对照组：男22例，女15例，年龄59～81岁，平均年龄(70.16±13.45)岁，Ⅰ级13例，Ⅱ级17例，Ⅲ级7例。两组患者在性别、年龄、AHA/ASA分级等一般资料上差异无统计学意义(P>0.05)，一般资料具有可比性。两组患者均无心、肝、肾严重疾病史，无精神障碍、脑梗死、颅脑外伤史，所有患者均签署知情同意书且经院伦理委员会批准同意。, http://www.100md.com(李建平 陈森林 蔡青 邹渊)