国际麻醉学与复苏杂志   2011, Issue (6): 7-7
    
右美托咪啶对腹腔镜胆囊切除术全麻效果的影响
余骏马, 董春山, 陆姚, 朱海娟, 李蕾, 徐瑞好1()
1.安徽医科大学第三附属医院 合肥市第一人民医院
Effect of single dose dexmedetomidine on general anesthesia in laparoscopic cholecystectomy
 全文:
摘要:

[摘要] 目的 探讨预先注射小剂量右美托咪啶对腹腔镜胆囊切除术患者全麻效果的影响。方法 择期行腹腔镜胆囊切除术患者50例,ASAⅠ~Ⅱ级,年龄21~57岁,体重42.5~80kg,随机分成对照组(C组)和右美托咪啶组(D组)两组。C组在麻醉诱导前10min内静脉注射10ml生理盐水,D组以同样的方法静脉注射右美托咪啶0.6μg/kg,然后开始麻醉诱导。分别记录两组患者给药前(T0)、给药后5min(T1)、麻醉诱导前(T2)、注射丙泊酚后1min(T3)、注射丙泊酚后2min(T4) 、插管即刻(T5)、插管后1min(T6)、插管后3min(T7 )、手术开始即刻(T8,即插管后5min )的MAP、HR;记录麻醉诱导时间、麻醉时间、手术时间、麻醉结束至拔管时间、术毕患者清醒时间及拔管时患者有无呛咳反射;记录各病人异丙酚和舒芬太尼的用量;记录各组患者使用阿托品、麻黄素、利喜定及爱络的次数。结果 与C组比较,D组诱导时间缩短(P<0.01),拔管呛咳减少(P<0.05);丙泊酚和舒芬太尼用量减少;阿托品使用率增加(P<0.05),利喜定和爱络使用率减少(P<0.05)。C组T3~8各时间点MAP与T0 时比较,均下降(P<0.05);D组T1 时MAP升高(P<0.05);C组T3~8各时间点MAP较D组有所下降(P<0.05)。C组T4、 T5时HR下降(P<0.05);D组T1~8各时间点HR较T0时均下降(P<0.05);D组T1~3 和T6~8各时间点HR较C组下降(P<0.05)。结论 腹腔镜胆囊切除术全麻诱导前预先静脉注射小剂量右美托咪啶,可提高全麻质量。

关键词: [关键词] 右美托咪啶 腹腔镜胆囊切除术 全麻
Abstract:

[Abstract] Objective To observe the effect of single dose dexmedetomine(Dex) on general anesthesia in laparoscpic cholecystectomy. Methods Fifty ASA Ⅰ or Ⅱ patients of both sexes aged 21-57 kg undergoing elective laparoscopic cholecystectomy were randomly divided into 2 groups (n=25 each):dexmedetomine group and control group. Group C (control) received normal saline 10ml and the whole dose was given within 10 minutes. Group D received equal volume of Dex 0.6μg/kg intravenous injection as group C. MAP and HR were recorded at the time points of pre-administration of Dex(T0), 5min after administration(T1), before anesthesia induction(T2), 1 and 2 min after injecting propofol respectively(T3~4), immediately after intubation(T5), 1,3 and 5 min after intubation(T6~8). The following variables were also recorded: duration induction,duration of anesthesia and operation,extubation time,regain consciousness time,coughing when extubating,dosage of propofol or sufentanyl, frequency of cardioactive drug. Results The duration of induction was significantly shorter(P<0.01), coughing when extubating was decreased(P<0.05),and the requirements of propofol or sufentanyl were decrased(P<0.01), but the requirement of atropine was increased in group D than in group C(P<0.05). Compared with T0 or every time points of group D, MAP was significantly decreased at T3~8 in group C(P<0.05). MAP was significantly higher in group D at T1(P<0.05). HR was significantly low in group C at T4 and T5(P<0.05). In addition, HR was significantly low in group D at T1~8(P<0.05),and was significantly low in group D than in group C at T1~3 and T6~8(P<0.05). Conclusion A single dose of Dex given intravenously before induction is beneficial to patients in laparoscopic cholecystectomy. [Key words] dexmedetomidine; laparoscopic cholecystectomy; general anesthesia

Key words: [Key words] dexmedetomidine; laparoscopic cholecystectomy; general anesthesia