Objective To investigate the effect of dexmedetomidine on patient plasma norepinephrine and epinephrine levels during desflurane anesthesia. Methods Sitxty patients ( ASAⅠ~Ⅱ) scheduled for elective laparoscopic hysterectomy surgery were randomly divided into two groups:control group (n=30) and combined group (n=30). Patients in both of the two groups received desflurane anesthesia besides the regular treatment. In addition,patients in combined group received con-tinuous intravenous infusion of dexmedetomidine after induction of anesthesia,control group was given the same volume of sa-line. Heart rate,mean arterial pressure and the plasma levels of norepinephrine and epinephrine were examined at different time points during the operation. Meanwhile,the extubation time,incidence of intraoperative awareness and restlessness score were also recorded. Results Desflurane significantly increased the patient plasma norepinephrine and epinephrine levels (P＜0. 05). Compared to the control group,dexmedetomidine significantly decreased the heart rate,mean arterial pressure and the plasma norepinephrine and epinephrine levels. Moreover,dexmedetomidine significantly shortened the breathing recovery time and extubation time,lowered the restlessness score (P＜0. 05). Conclusion During desflurane anesthesia,dexme-detomidine reduces patient plasma norepinephrine and epinephrine levels and improves the quality of anesthesia.%目的 观察右美托咪啶对地氟醚麻醉期间血浆中去甲肾上腺素和肾上腺素水平的影响. 方法 回顾性分析ASAⅠ~Ⅱ级择期行腹腔镜下子宫次全切除手术60例病人,分为对照组(地氟醚组)和联合组(右美托咪啶与地氟醚联合麻醉组),每组30例. 两组术前和诱导用药相同,联合组麻醉诱导后开始每小时静脉输注右美托咪啶0. 5μg/kg并维持至麻醉结束. 对照组在麻醉诱导后静脉注射给予相同体积的生理盐水. 于麻醉诱导前( T0 )、吸入地氟醚30 min后(T1)、手术开始后60 min(T2)及关腹膜后即刻(T3)分别抽取中心静脉血,测定血浆肾上腺素(EP)和去甲肾上腺素(NE)浓度;观察心率(HR)、平均动脉压(MAP)和呼吸恢复、拔管时间、术中知晓发生率以及苏醒期躁动评分. 结果 与T0 比,两组T1、T2 和T3 EP和NE水平明显升高(P＜0. 05);与对照组比较,联合组T1、T2和T3 EP和NE水平明显降低(P＜0. 05),HR减慢、MAP降低、呼吸恢复时间、拔管时间缩短(P＜0. 05),苏醒期躁动的评分减低(P＜0. 05). 结论 右美托咪啶可以降低地氟醚麻醉期间血浆中去甲肾上腺素和肾上腺素水平.
展开▼
