右美托咪定对高血压患者全身麻醉苏醒期躁动及血流动力.pdf

中国药物与临床2012年2月第12卷第2期ChineseRemedies&Clinics，February2012,Vol.12,No.2··157

右美托咪定对高血压患者全身麻醉苏醒期
躁动及血流动力学的影响

章玲宾樊理华卢向红楼天正何仁洪陈琴游敏吉

!!!!!!【摘要】目的观察右美托咪定对高血压患者全身麻醉苏醒期躁动和血流动力学的影响。方法选择
既往有高血压病史，血压控制稳定，择期行胃癌根治手术的患者４０例。随机分成右美托咪定组（Ｄ组）和生理盐
水组（Ｃ组），均采用静吸复合全身麻醉，手术结束前６０ｍｉｎＤ组静脉微泵注射右美托咪定０．５μｇ/ｋｇ（用生理盐
水２０ｍl稀释）；Ｃ组静脉微泵注射生理盐水２０ｍl。结果Ｄ组躁动明显低于Ｃ组（Ｐ＜０．０１）；Ｄ组患者术后１ｈ
的视觉模拟镇痛（ＶＡＳ）评分明显低于Ｃ组（Ｐ＜０．０１）；而Ｃ组围拔管期各时点的平均动脉压（ＭＡＰ）、心率（ＨＲ）明
显高于Ｄ组相应时点值（Ｐ＜０．０１或Ｐ＜０．０５）。结论右美托咪定能有效减少高血压患者全身麻醉术后躁动发生
率及血流动力学的变化。
【关键词】高血压；右美托咪定；苏醒期躁动；血流动力学

EffectsofDexmedetomidineonagitationandhemodynamicstatusduringrecoveryperiodfromgeneralanes鄄
thesiainpatientswithhypertensionZHANGLing鄄bin,FANLi鄄hua,LUXiang鄄hong,LOUTian鄄zheng,HERen鄄
hong,CHENQin,YOUMin鄄ji.DepartmentofAnesthesiology,ZhejiangLishuiPeople′sHospital,SixthAffiliatedHos鄄
pitalofWenzhouMedicalCollege,Zhejiang323000,China
【Abstract】ObjectiveTodeterminetheeffectsofDexmedetomidineonagitationandhemodynamicstatusdur鄄
ingrecoveryperiodfromgeneralanesthesiainpatientswithhypertension.MethodsAtotalof40patientswithpast
historyandcurrentlygoodcontrolofhypertension,andscheduledforselectiveradicalresectionofgastriccancer,were
recruitedinthisstudy.Thesubjectswererandomlyassignedintodexmedetomidinegroup(GroupD)andnormalsaline
group(GroupC),toreceiveintravenousplusinhalationanesthesia.At60minutespriortotheendofsurgery,patients
inGroupDweresubjecttointravenousdexmedetomidineviamicropumps(0.5μg/kg,dilutedin20mlnormalsaline),
whileGroupCreceived20mlintravenousnormalsalineviamicropumps.ResultsLessagitationwasobservedin
GroupDascomparedwithgroupC(P<0.01).At1hourafteroperation,thevisualanaloguescale(VAS)ofpainwas
significantlyloweredinGroupDthanthatingroupC(P<0.01).PatientsinGroupCexperiencedsignificantlyhigher
meanarterialpressureandheartrateatseveraltimepointsduringperi-extubationperiodthanthoseingroupD(P<
0.01or0.05).ConclusionDexmedetomidineiseffectiveinreducingagitationandsecuringhemodynamicstatusdur鄄
ingrecoveryperiodfromanesthesiainpatientswithhypertension.
【Keywords】Hypertension；Dexme