目的：探讨不同剂量右美托咪定（ dexmedetomidine ，DEX）复合依托咪酯行全身麻醉（全麻）诱导的麻醉效果。方法选取120例ASA分级Ⅰ～Ⅱ级择期全麻手术患者，随机分为4组（n＝30）：对照组（C组）、1．0μg／kg DEX组（D1组）、0．75μg／kg DEX组（D2组）、0．5μg／kg DEX组（D3组）。监测并记录 DEX或生理盐水匀速静脉输注（注射）前（T0）、注射后（T1）、注射完成后5 min（T2）、气管插管（插管）前（T3）、插管完成时（T4）、插管完成后2 min（T5）、3 min（T6）各时间点的平均动脉压（MBP）、心率（HR）、脉搏氧饱和度（SpO2）、脑电双频指数（ BIS）值、镇静评分（ OAA／S）等。结果 C组患者气管插管前后HR、MAP、BIS上升显著，差异有统计学意义（ P＜0．05）。与C组比较，在T1、T2时刻， D1－2组HR、BIS显著下降，差异有统计学意义（P＜0．05）；T4－6时刻，D1－3组HR、MAP、BIS波动较小，差异有统计学意义（P＜0．05）；D1－2组依托咪酯用量显著减少，差异有统计学意义（P＜0．05）。 D1－3组麻醉苏醒无延迟，与C组比较差异无统计学意义（P＞0．05）。结论 DEX复合依托咪酯行全麻诱导对维持患者血流动力学稳定有较好效果，且不影响全麻苏醒时间。%Objective To evaluate the general anesthesia induced by different doses of dexmedetomidine ( DEX ) combined with etomidate .Methods A total of 120 ASAⅠ-Ⅱpatients were enrolled in the current study who under-went surgery under general anesthesia condition .They were randomly divided into four groups (n=30):a control group (Group C), a 1.0 μg/kg Dex group (Group D1), a 0.75 μg/kg Dex group (Group D2) and a 0.5 μg/kg Dex group (Group D3).The mean blood pressure (MBP), heart rate (HR), SPO2, bispectral index (BIS), and Observer′s as-sessment of alertness/sedation ( OAA/S) scores were recorded before injection of Dex ( T0 ) , immediately after injection of DEX ( T1 ) , 5 minutes after injection of Dex ( T2 ) , before intubation ( T3 ) , immediately after intubation ( T4 ) , 2 and 3 minutes after the intubation (T5 and T6).Results After intubation, patients in Group C produced remarkable increa-ses in HR, MAP, and BIS in comparison with those before intubation (P<0.05).Compared with Group C, HR and BIS were decreased markedly in Groups D1 and D2 at T1 and T2(P<0.05).Groups D1, D2, and D3 showed less changes in HR, MAP and BIS from T4 to T6(P<0.05).The doses of etomidate used in Groups D1 and D2 were significantly re-duced (P<0.05).The recovery time of patients in Groups D1, D2 and D3 were not extended, which were not statistical different from that of Group C (P>0.05).Conclusion Dex combined with etomidate can stabilize patients′hemody-namic parameters under general anesthesia condition , and does not extend recovery time .
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