【摘要】 目的探讨右美托咪定对甲状腺手术颈丛阻滞麻醉患者心率变异性的影响。方法选择择期行甲状腺次全切或全切手术的甲状腺瘤或甲状腺肿患者50例,随机分为观察组和对照组各25例。观察组将右旋美托咪定以1.0μg/kg在术前15 min静脉泵注,对照组以相同容量生理盐水术前静脉注入。于麻醉前(T0)、切皮时(T1)、分离腺体(T2)、缝合皮肤(T3)各点分别记录各组患者心率(HR)、HRV参数值作为观察指标。结果观察组患者各时间点HR变化及HF、LF无显著差异(P>0.05),而对照组差异显著(P<0.05)。观察组和对照组比较T1、T2、T3时间点的HR、TP、LF、HF差异显著(P<0.05)。结论右美托咪定用于甲状腺手术颈丛阻滞麻醉,可以减轻手术应激反应时血流动力学的急剧变化,维持HRV近似麻醉前水平,尤其对心血管系统损害的患者更为有益。更多还原

【Abstract】 Objective To investigate the effects of dexmedetomidine on the heart rate variability(HRV) in patients suffered with thyroid surgery by cervical plexus anesthesia.Methods A total of 50 patients diagnosed to thyroma and thyroncus suffered with subtotal or total thyroidectomy were been chosen and divided into two groups randomly,each of 25 cases.The patients in observation group were accepted with dexmedetomidine by intravenous infusion 1.0 μg/kg at 15min before the operation.The patients in control group were accepted with the same volume of normal saline by intravenous injection.The indexes of heart rate(HR) and HRV parameters in two groups were recorded at before anesthesia(T0),skin incision(T1),isolated glands(T2),skin suture(T3).Results The indexes of HR,HF and LF in observation group were no different among four time-points(P>0.05),but the indexes of HR,HF and LF in control group were different among four time-points(P<0.05).Compared to control group,the indexes of HR,TP,HF and LF in observation group were different at T1,T2,T3 time-point(P<0.05).Conclusion During thyroid operation in cervical plexus block anesthesia,dexmedetomidine can reduce dramatically hemodynamic stress response in the operation,maintenance of HRV approximate level before anesthesia;especially for patients with cardiovascular system damage are more useful.更多还原