右美托咪定预防老年高血压患者全麻气管插管和拔管时心血管反应探究.docVIP

右美托咪定预防老年高血压患者全麻气管插管和拔管时心血管反应探究 　　【摘要】 目的 探讨右美托咪定（dexmedetomidine， Dex）用于老年高血压患者全麻期间预防气管插管和拔管时心血管反应的临床效果及安全性。方法 选择80例在本院行外科手术ASA Ⅱ～Ⅲ级伴高血压老年患者， 随机双盲分为A（观察）组（n=40， 气管插管前静注0.5 μg/kg Dex）和B（对照）组（n=40， 气管插管前静注等量0.9%NS）。记录两组患者麻醉诱导前（T0）、诱导后5 min （T1）、插管后即刻（T2）、插管后2 min （T3）、拔管后即刻（T4）、拔管后2 min （T5）等时点的HR、SBP、DBP、SpO2的变化；观察两组麻醉时间、拔管时间、患者在PACU1h内意识状态、麻醉合并症及不良反应。结果 两组患者麻醉时间、拔管时间差异无统计学意义。两组T1及A组其它时间点HR、SBP和DBP与T0比较明显降低（P0.05）。结论 Dex可安全静脉泵注用于全麻老年高血压患者， 能有效地预防气管插管和拔管时的心血管反应。 【关键词】 右美托咪定；老年患者；高血压；心血管反应；麻醉， 全身 Study of dexmedetomidine on prevention of the cardiovascular response during intubation and extubation in old aged patients with hypertension in general anesthesia ZHENG Chan， FENG Yu-feng， SUN Cai-hong. Department of Anesthesiology， First Affiliated Hospital of Xiamen University， Xiamen 361003， China 【Abstract】 Objective To investigate the clinical effects and safety of dexmedetomidine （Dex） on prevention of the cardiovascular response during intubation and extubation in old aged patients with hypertension in general anesthesia. Methods 80 elective old aged patients with hypertension， ASA grade II～Ⅲ， undergoing surgery under general anesthesia were double-blinded randomly allocated to two groups with 40 cases each. Group A （n = 40） received Dex 0.5 μg/kg and group B （n=40） received the same volume normal saline. HR， SBP， DBP were recorded before anesthesia （T0）， after induction （T1）， at the time of intubation（T2）， 3 min after intubation （T3）， at the time of extubation （T4） and 3 min after extubation （T5）. The complications and adverse reactions of anesthesia were recorded during each operation. anesthetic time、extubation time and patients` consciousness in 1 hour during PACU were observed and recorded. Results Anesthetic time and extubation time were not significantly different in the two groups （P0.05）. HR、SBP、DBP were found significantly lower than baseline at the time of T1 in both groups and at other time point in group A （P0.05）. Conclusion It is safety to pump