小剂量右美托咪定预防老年人全麻拔管期间心血管反应的效果研究

摘要

Objective:To study the effect of small dose of dexmedetomidine on preventing cardiovascular response during extubation in elderly patients under general anesthesia. Methods:100 elderly patients undergoing general anesthesia by rapid intravenous induction and intubation hos-pitalized from January 2011 to May 2014 were randomly divided into the observation group ( dexmedetomidine group) and the control group ( physi-ological saline group), with 50 cases in each group. The observation group received intravenous dexmedetomidine 0.4 ug·kg-1 (diluted to 50 mL by physiological saline )10 min before the operation was finished and the control group received 50 mL physiological saline. The changes of heart rate ( HR) , systolic blood pressure ( SBP) , diastolic blood pressure ( DBP) , time of awakening and blood gas results of the two groups were recorded before and after extubation. Results: There was no difference in time of awakening and blood gas results between the two groups ( P >0. 05). In the observation group HR during the operation was lower than that before the operation ( P <0. 05) and DBP and HR were slightly higher than those before the operation ( P >0. 05);compared with those of before the operation , there was no difference in HR,SBP and DBP 3 and 5 min after the operation. In the control group, HR, SBP and DBP during the operation were higher than those before the operation and those of the observation group (P<0. 05). Conclusion:Dexmedetomidine can be used in elderly patients during recovery period of extubation, maintain hemodynamic stability and does not affect the time of extubation.%目的：：研究小剂量右美托咪定预防老年人全麻拔管期间心血管反应的效果。方法：将2011年1月至2014年5月间择期行全麻下经口快速静脉诱导插管的100例老年患者随机分为观察组(右美托咪定组)和对照组(生理盐水组),每组各50例。手术结束前10 min观察组静注右美托咪定0.4 ug/kg(生理盐水稀释至50 mL),对照组静注50 mL生理盐水。记录两组患者拔管前后各时间点的心率( heart rate,HR)、收缩压( systolic blood pressure ,SBP)、舒张压( dias-tolic blood pressure,DBP)变化及术后清醒时间、血气结果。结果：两组患者术后清醒时间及血气结果比较无差异( P >0.05)；与术前相比,术中观察组HR降低( P <0.05),SBP、DBP均略有上升( P >0.05)。术后3 min、5 min时HR、SBP、DBP与术前无差异( P >0.05),对照组HR、SBP、DBP在术中均高于术前,且高于观察组( P <0.05)。结论：右美托咪定用于老年患者苏醒期拔管,血流动力学稳定,且不影响拔管时间。