右美托咪定对高血压患者全身麻醉苏醒期躁动及血流动力学的影响

摘要

Objective To determine the effects of Dexmedetomidine on agitation and hemodynamic status during recovery period from general anesthesia in patients with hypertension. Methods A total of 40 patients with past history and currently good control of hypertension, and scheduled for selective radical resection of gastric cancer, were recruited in this study. The subjects were randomly assigned into dexmedetomidine group (Group D) and normal saline group (Group C), to receive intravenous plus inhalation anesthesia. At 60 minutes prior to the end of surgery, patients in Group D were subject to intravenous dexmedetomidine via micropumps (0.5 μg/kg, diluted in 20 ml normal saline), while Group C received 20 ml intravenous normal saline via micropumps. Results Less agitation was observed in Group D as compared with group C (P<0.01). At 1 hour after operation, the visual analogue scale (VAS) of pain was significantly lowered in Group D than that in group C (P<0.01). Patients in Group C experienced significantly higher mean arterial pressure and heart rate at several time points during peri-extubation period than those in group D (P< 0.01 or 0.05). Conclusion Dexmedetomidine is effective in reducing agitation and securing hemodynamic status during recovery period from anesthesia in patients with hypertension.%目的 观察右美托咪定对高血压患者全身麻醉苏醒期躁动和血流动力学的影响.方法 选择既往有高血压病史.血压控制稳定,择期行胃癌根治手术的患者40例.随机分成右美托咪定组(D组)和生理盐水组(C组),均采用静吸复合全身麻醉,手术结束前60 min D组静脉微泵注射右美托咪定0.5μg/kg(用生理盐水20ml稀释);C组静脉微泵注射生理盐水20ml.结果 D组躁动明显低于c组(P<0.01);D组患者术后1 h的视觉模拟镇痛(VAS)评分明显低于C组(P<0.01);而C组围拔管期各时点的平均动脉压(MAP)、心率(HR)明显高于D组相应时点值(P<0.01或P<0.05).结论右美托咪定能有效减少高血压患者全身麻醉术后躁动发生率及血流动力学的变化.