右美托咪定联合丙泊酚对全麻血流动力学的影响(1)
 |
| 第1页 |
参见附件(2962KB，3页)。
[摘要] 目的 探讨右美托咪定联合丙泊酚用于全身麻醉中的安全性及有效性。 方法 选择静吸复合全麻手术患者90例，ASAⅠ～Ⅱ级，随机分为右美托咪定组(D组)、丙泊酚组(P组)、右美托咪定联合丙泊酚组(DP组)，每组30例。术中根据麻醉深度指数值(CSI)调节右美托咪定或丙泊酚的用量，记录用药前、诱导前、插管前和后、切皮前及拔管后血流动力参数，并记录拔管时间、复苏时间及围术期不良反应的发生情况。 结果 与P组相比，DP组以及D组患者的平均动脉压及心率波动较小，差异有统计学意义(P < 0.05)；D组苏醒时间与P组、DP组相比，D组苏醒时间较长，差异有统计学意义(P < 0.05)。 结论 右美托咪定联合丙泊酚在静吸复合全麻手术中使用，可减少全身麻醉药用量，稳定血流动力学作用，且减少不良反应。
[关键词] 右美托咪定；丙泊酚；麻醉；静脉
[中图分类号] R614.2 [文献标识码] B [文章编号] 1673-9701(2012)03-0094-03
Effect of dexmedetomidine combined with propofol in haemodynamics with general anesthesia patients
HU Fang YU Guocan
Department of Anesthesiology, the People's Hospital of Fuyang City in Zhejiang Province, Fuyang 311400, China
[Abstract] Objective To evaluate the efficacy and safety of dexmedetomidine(DEX) combined with propofol used in general anesthesia patients. Methods All of 90 patients practicing general anesthesia, ASAⅠ-Ⅱ were randomly divided into three groups (n = 30). Propofol group (P group), DEX group (D group) and DEX combined with propofol group (DP group). In three groups the DEX or propofol target plasma concentration was adjusted according to cerebral state index (CSI). The patients in three groups were under same anesthesia induction. Hemodynamic changes and propofol effectsite concentration were recorded before drug using, before induction of anesthesia, immediately before and after tracheal intubation, before skin incision, 30 min after skin incision and after extubation. Recovery time and adverse reactions were also recorded. Results Compared with group P, MAP and HR fluctuations caused by tracheal intubation were well controlled in group DP and group D (P < 0.05); The time from the end of surgery to eye opening of group D was longer than that in group P and group DP (P < 0.05). Conclusion DEX combined with propofol used in general anesthesia patients can reduce the dose of propofol, keep hemodynamics index relatively stable, and reduce adverse reactions.
[Key words] Dexmedetomidine; Propofol; Anesthesia; Intravenous
在以往的临床应用中，丙泊酚因其良好的镇静、遗忘作用、起效迅速、半衰期短等优点，常用于全身麻醉的诱导和维持。而右美托咪定作为新型高选择性α2-受体激动药，有镇静、镇痛等优点，多用于ICU患者和非全麻患者辅助用药。有学者发现[1，2]，在以RSS和脑电双频指数评价镇静深度时，右美托咪定与丙泊酚的镇静效果相似。本研究采用麻醉深度指标和连续血流动力学监测，观察右美托咪定、丙泊酚及右美托咪定联合丙泊酚在相同的麻醉环境下，用于全身麻醉维持时对血流动力学的影响及不良反应的发生，现报道如下。
1 资料与方法
1.1 病例选择 ......
您现在查看是摘要介绍页，详见PDF附件(2962KB，3页)。