【摘要】 目的观察不同剂量右美托咪定在全麻插管期应激反应的影响。方法选择90例择期行胃癌根治术的患者,随机分为三组,每组各30例。中剂量组(D1组)给予右美托咪定0.5μg/kg;高剂量组(D2组)给予0.8μg/kg;C组给予等量的生理盐水。以上各组药物均于麻醉诱导前10min内用微量泵输入。记录三组患者:入室时(给予右美托咪定前)(T0)、气管插管前(T1)、气管插管毕即刻(T2)、切皮前(T3)各时点心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、血浆皮质醇(Cor)和血糖(Glu)浓度。记录不良反应如:高血压、心动过缓、寒颤等的例数。结果 T2时点C组HR、SBP、DBP、MAP明显高于D1、D2组(P<0.05);T3时点C组的Cor、Clu浓度高于D1、D2组(P<0.05)。组内比较:C组各时点血流动力学波动明显(P<0.05),而D1、D2组波动不大(P>0.05)。不良反应例数D2组明显多于D1组。结论中剂量右美托咪定抑制气管插管引起的应激反应更安全有效。更多还原

【Abstract】 Objective To observe the effects of different doses of dexmedetomidineon on stress reflect to endotrachael intubation.Methods Totally 90 patients undergo radical operation for gastric cancer were subjected.They were randomly divided into three groups,30 cases in each group.Median dose dexmedetomidine group(group D1)were given 0.5ug/kg,and 0.8ug/kg for the high dose dexmedetomidine group(group D2),while group C was offered the same amount of physiological saline.The above liquid was all pumped within 10 min before endotrachael intubation.The parameters of heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP)were recorded in the following time:just entering operating room(before Dex be given)(T0);immediately before intubation(T1);immediately afert intubation(T2);before cut the skin(T3).The palsma corticosteroid(Cor)and glucose(Glu)of the arterial blood were measured.Adverse reactions were recorded such as hypertension,bradycardia,chill and so on.Results Group C compared with group D1 and D2 of hemodynamic had obviously statistical differences at the time of T2(P<0.05),and Cor and Glu in group C were higher than group D1 and D2 at T3 time(P<0.05);Comparison within groups:the comparison of hemodynamic had obviously differences(P<0.05)within group C in each time,but there was little changes between group D1 and D2(P>0.05).The adverse reaction cases of group D2 were more than group D1.ConclusionContinuous infusion of middle dose of dexmedetomidine is the best on control the stress reflect for the patients undergoing general anesthesia of endotrachael intubation.更多还原