| 杨曦仑,代玉婷,姜美玲,孙雪晨,马 铃.经胸超声评价右美托咪定对麻醉插管前后循环功能影响[J].,2018,(3):463-466 |
| 经胸超声评价右美托咪定对麻醉插管前后循环功能影响 |
| Effect of Dexmedetomidine on the Circulation during the Intubation through Transesophageal Echocardiography |
| 投稿时间：2017-10-25 修订日期：2017-11-16 |
| DOI：10.13241/j.cnki.pmb.2018.03.013 |
| 中文关键词: 右美托咪定 心脏超声 气管插管 循环 |
| 英文关键词: Dexmedetomidine Cardiac ultrasound Intubation Circulation |
| 基金项目:国家自然科学基金项目（81302534） |
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| 中文摘要: |
| 摘要 目的：探讨在诱导前给予预注射右美托咪定对于全麻患者麻醉诱导期插管前后循环影响。方法：选择拟行择期手术患者60例并将其随机分为3组，每组20例。D1组在入室后5 min内泵入0.2 μg?kg-1盐酸右美托咪定，D2组于入室后5 min内泵入0.4 μg?kg-1盐酸右美托咪定，C组于入室后5 min内泵入等容积量生理盐水。比较三组患者在给药前(T0)、给药15 min后(T1)以及插管成功后(T2)左室舒张末期容积(EDV)、左室收缩末期容积(ESV)、射血分数(EF%)、心输出量(CO)、每搏量(SV)以及同时期的平均动脉压、心率变化。结果：在T1时，D1、D2组患者EDV、ESV、EF%、CO、SV、平均动脉压、心率与对照组比较差异均无统计学意义(P>0.05)。而在T2时，D1组心率、平均动脉压以及CO均较C组明显降低，D2组心率、平均动脉压、心输出量、每搏量、左室舒张末期容积较C组低，左室收缩末期容积较C组高(P<0.05)。结论：麻醉诱导前给予0.4 μg/kg盐酸右美托咪定可以更好的改善诱导期心脏负荷和心功能，并减轻插管引起的交感神经兴奋导致的循环波动。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect of preoperative administration of dexmedetomidine during the intubation on the circula- tion. Methods: The study was performed in 60 cases of patients undergoing elective surgery which were randomly divided into three groups, with 20 patients in each group. In group D1 and D2, the patients were given 0.2 μg?kg-1 or 0.4 μg?kg-1 dexmedetomidine in 5 min after the patients coming into the operation room respectively. And group C was given the same volume of saline in 5 min after the patients coming into the operation room as control group. Then the heart rate(HR), mean arterial pressure (MAP), left ventricular end sys- tolic volume(ESV), left ventricular end diastolic(EDV), left ventricular ejection fraction(EF%), stroke volume(SV), and cardiac output(CO) which were monitored in three times: after the patients coming into the operation room(T0), at 15 min after finished administration dexmedetomidine or saline(T1), and after intubation(T2), were compared among three groups. Results: Although no significant differ- ence was found in the EDV, ESV, EF%, CO, SV, mean blood pressure and heart rate among three groups at T1, differences could be seen at T2. In group D1, HR, MAP, and CO were decreased significantly compared with group C(P<0.05). Meanwhile, the reduction of HR, MAP, CO, SV, EDV and EF became significantly decreased but increased in ESV when using 0.4 μg?kg-1 dexmedetomidine before in- duction(P<0.05). Conclusion: Administration of 0.4 μg?kg-1 dexmedetomidine could effectively decrease the sympathetic tone and car- diac load, which could protect the cardiac function and inhibit the circular wave caused by the stress response to the intubation during the induction of anesthesia. |
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