右美托咪啶对全身麻醉患者气管拔管期应激反应的影响.pdf

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1、江苏医药2013年4月第39卷第8期Jian~suMedJ，ADril2013，Vol39，No．8·论著·右美托咪啶对全身麻醉患者气管拔管期应激反应的影响汪树东李娟康芳方才【摘要】目的探讨右美托咪啶(Dex)对全麻患者气管拔管期应激反应的影响。方法行颅内肿瘤切除术患者6O例随机均分为两组，术前泵注Dex0．6／~g／kg(A组)或等量生理盐水(B组)。观察麻醉前(，I、0)、拔管前1min(T1)、拔管即刻(T2)、拔管后5rain(T3)和10min(T4)的MAP、HR、麻醉深度指数(CSI)和Sp()z的变化，并测

2、定各时点颈内静脉血中葡萄糖(BG)和皮质醇(Cor)浓度，记录患者呼吸恢复时间、苏醒时间和拔管时间、呛咳评分、拔管后警觉镇静(OAA／S)评分、词语等级镇痛评分(VRS)和术后躁动评分。结果与B组相比，T1一T3时A组拔管后MAP和HR明显降低(P0．o5)。与B组相比，A组拔管期呛咳发生率和呛咳评分明显降低，麻醉苏醒期躁动发生率、躁动评分和VRS疼痛评分均明显降低(P

3、管期应激反应，稳定循环功能。【关键词】右美托咪啶；应激反应【中图分类号】R651【文献标识码】A【文章编号】0253—3685(2O13)O8一O9O5一O4Efectsofdexmedetomidineonstressresponsetoextubationinpatientsundergoinggeneralarmesthesia4ⅣGShudong，L，Juan，，efa1．Departmentoi'Anesthesiology，AnhuiProvincialHospital，AnhuiMedicalUniversi

4、ty，Hefei230001，cH[AbstractIObjectiveToinvestigatetheeffectsofdexmedetomidineonstressresponsetoextubationinthepatientsundergoinggeneralanaesthesia．MethodsSixtypatientsundergoingintracranialtumorresectionwereequallyrandomizedintotwogroupsofA(dexmedetomidineO．6t,g／kg

5、Iv．beforeoperation)andB(equivalentnormalsalineascontro1)．MAP，HR，cerebralstateindex(CSI)andSp02wererecordedbeforeanesthesia(TO)，at1minutebeforeextubation(T1)，immediateafterextubation(T2)，5minutes(T3)and10minutes(T4)afterextubation．B1oodglucose(BG)andcortisolweredet

6、ected，thetimesofbreathingrecovery，awakeningandextubationwererecorded．Thescoresofcough，OAA／Ssedation，verbalratingscale(VRS)，andpostoperativeagitationwererecordedaswel1．ResultsComparedwithgroupB，MAPandHRweresignificantly1oweratT1一T3ingroupA(P~0．05)，BGandcortisolwere

7、significantlyloweratT1—T4ingroupA(P

8、sresponsetoextubationandstabilizecirculationinpatientsundergoinggeneralanaesthesia．[Keywords]Dexmedetomidine；Stressresponse~JiangsuMedJ，April2013，39(8)：