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时间:2020-05-02
《右美托咪定对全麻下老年患者全膝关节置换术应激反应和拔管反应的影响.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、临床麻醉学杂志2013年1O月第29卷第lO期JclinAnesthesiol,October2013,Vo1.29,No.10老年麻醉专辑.临床研究.右美托咪定对全麻下老年患者全膝关节置换术应激反应和拔管反应的影响张珍妮雷晓鸣吕建瑞邓蕊薛荣亮【摘要】目的探讨右美托咪定对全麻下老年患者全膝关节置换术(TKA)应激反应和拔管反应的影响。方法择期在全麻下行TKA的老年患者4O例,ASAI~Ⅲ级,年龄65~78岁,随机数字表法分为右美托咪定组(D组)和生理盐水对照组(C组)。D组麻醉诱导前泵注右美托咪定,负荷剂量0.5/,10min泵完,以0.4·kg·h维持;C组以
2、同样方式泵注等量生理盐水。观察并记录给药前(To)、给药后10min(T)、气管插管时(Tz)、切皮时(T3)、放置骨水泥(T4)、术毕(Ts)、拔管后(T)的MAP、HR。于T0、T2及Ts时检测肾上腺素(E)、去甲肾上腺素(NE)的血浆浓度。记录拔管期间的呼吸恢复时间、拔管时间、苏醒时间、呛咳评分和躁动评分。结果与T0时比较,T~T5时D组和T3、T4时c组MAP明显降低(PG0.05);T4、T5时D组HR明显减慢(尸G0.05);T2、T6时c组血浆E、NE浓度明显升高(PGO.05)。与c组比较,D组T1~时MAP明显降低(PG0.05);T2~T6时
3、HR明显减慢(P<0.05);Tz、T6时D组患者E、NE浓度明显降低(P4、tionqualityinelderlypatientsundergoingtotalkneearthroplastywithgeneralanesthesiaZHANGZhen-ni,删Xiao-ming,LJian-rui,DENGRui,XUERong-liang.DepartmentofAnesthesiology。eSecondAfiliatedHospitalofXi’aftJiaotongUniversity,CollegeofMedicine,"an710004,ChinaCorrespondingauthor:脚Rong-liang,Email5、:xuerl@china.com[Abstract]ObjectiveToinvestigateeffectsofdexmedetomidineonstressreactionandextubationqualityinelderlypatientsundergoingtotalkneearthroplasty(TKA)withgeneralanesthesia.MethodsFortyelderlypatientswithASA工~Ⅲ,aged65—78yearsold,undergoingTKAwithgeneralanesthesia,wererandom6、lydividedintoDexgroup(groupD)andnormalsalinegroup(groupC).Dexmedetomidinewasgivenwitho.5ug/kgwithin10minbeforeanesthesiainductionandfollowedwith0.4g·kg一·h一ingroupDTheequalvolumeofnormalsalinewasinfusedingroupC.HR,MAPwereobservedatthetimebeforedexmedetomidineinfusion(To),10minafterdex7、medetomidineinfusion(T1),immediatelyafterintubation(),skinincision(T3),implantationofbonecementimmediately(T4),surgerycompletion(T5)andafterextubation(T6).TheplasmaconcentrationofepinephrineandnorepinephrineweredetectedatTo,TzandT6.Theintraoperativeuseofvasoactivedrugwasrecorded.Ther8、espiratoryre
4、tionqualityinelderlypatientsundergoingtotalkneearthroplastywithgeneralanesthesiaZHANGZhen-ni,删Xiao-ming,LJian-rui,DENGRui,XUERong-liang.DepartmentofAnesthesiology。eSecondAfiliatedHospitalofXi’aftJiaotongUniversity,CollegeofMedicine,"an710004,ChinaCorrespondingauthor:脚Rong-liang,Email
5、:xuerl@china.com[Abstract]ObjectiveToinvestigateeffectsofdexmedetomidineonstressreactionandextubationqualityinelderlypatientsundergoingtotalkneearthroplasty(TKA)withgeneralanesthesia.MethodsFortyelderlypatientswithASA工~Ⅲ,aged65—78yearsold,undergoingTKAwithgeneralanesthesia,wererandom
6、lydividedintoDexgroup(groupD)andnormalsalinegroup(groupC).Dexmedetomidinewasgivenwitho.5ug/kgwithin10minbeforeanesthesiainductionandfollowedwith0.4g·kg一·h一ingroupDTheequalvolumeofnormalsalinewasinfusedingroupC.HR,MAPwereobservedatthetimebeforedexmedetomidineinfusion(To),10minafterdex
7、medetomidineinfusion(T1),immediatelyafterintubation(),skinincision(T3),implantationofbonecementimmediately(T4),surgerycompletion(T5)andafterextubation(T6).TheplasmaconcentrationofepinephrineandnorepinephrineweredetectedatTo,TzandT6.Theintraoperativeuseofvasoactivedrugwasrecorded.Ther
8、espiratoryre
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