腹腔镜手术中右美托咪定对眼内压的影响-麻醉学专业论文.docxVIP

PAGE PAGE 2 Intraocular Pressure Changes During Laparoscopy in Patients Anesthetized with Dexmedetomidine Abstract Objective To investigate IOP changes during laparoscopy under general anesthesia combined with dexmedetomidine as a adjuvant. Methods 40 patients, ASA physical status I～II, pneumoperitoneum time longer than 1 hour, scheduled for laparoscopy surgery,were randomly divided into two groups with 20 patients in each:dexmedetomidine group(group D) premedicated by i.v. dexmedetomidine 1ug/kg ,and maintained with dexmedetomidine 0.4 ug/kg/h;placebo group(group P)saline of the same volume was given. After the anesthetic induction and tracheal intubation,the patients were ventilated by IPPV in mixed air.Anesthesia was maintained by propofol, sevofluence, sufentanil and Cisatracurium Besilate.Mean artery pressure(MAP),Heart rate(HR),Intraocular pressure(IOP),Partial pressure of end-tidal carbon dioxide(PetCO2) and Airway pressure were recorded at the time of 10 minutes after entered the operation room(T0),5 min after induction(T1),5 min after pneumoperitoneum(T2),30 min after pneumoperitoneum(T3),60 min after pneumoperitoneum(T4),5 min after evacsuation of pneumoperitoneum (T5) ,30 min after evacuation of pneumoperitoneum(T6).Results the intraocular pressure after pneumoperitoneum in the placebo group significantly increased compared with dexmedetomidine group（P 0.05）.The heart rate, blood pressure in dexmedetomidine group is generally lower and less fluctuated than the placebo group. Conclusion Application of dexmedetomidine in laparoscopic surgery can prevent the increase of intraocular pressure after pneumoperitoneum.Application of dexmedetomidine in laparoscopic surgery can maintain the hemodynamic stability in the process of pneumoperitoneum . Key words: Laparoscopy, Dexmedetomidine, Intraocular pressure, Pneumoperitoneum. 引言 眼内压是眼球内容物，包括晶状体、玻璃体、视网膜、眼球内的房水和血液 等，作用于眼球内壁的压力。如果眼内压超过了眼球内各组织（包括角膜、虹膜、 晶状体和玻璃体）尤其是视网膜视神经所能承受的限度，将会导致眼球在物理及 生理的变化，渐渐出现不可逆转的视神经病变[1]。