右美托咪啶对麻醉诱导双腔支气管内插管应激反应的影响.pdf

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1、医学临床研究2014年6月第3I卷第6期JClinRes，Jun．2014。Vol31，№6论著右美托咪啶对麻醉诱导双腔支气管内插管应激反应的影响唐莉(中国人民解放军三六三医院麻醉科，四川成都610041)[摘要]【目的】观察麻醉诱导前预注右美托咪啶对双腔支气管内插管患者应激反应的影响。【方法】本院59例全身麻醉下行肺或食管手术的患者，随机分为两组：对照组(C组，一29)，试验组(D组，一30)，D组在诱导前接受静脉输注右美托咪啶(O．6~g／kg)，C组则静脉注射等量生理盐水。随后使用靶控输注丙泊酚，血浆靶浓度为3t~g／mL，静脉注射舒芬太尼(O．3>g／kg)和顺

2、阿曲库铵0．2mg／kg，5min后行双腔气管插管。分别在麻醉诱导前(T。)、气管插管后即刻(T)抽血，采用高效液相色谱法检测血浆肾上腺素与去甲肾上腺素含量，观察并记录T。、气管插管前(T)和T2平均动脉压(MAP)及心率(HR)变化。【结果】D组与C组在T。与T1时间点比较，MAP及HR没有明显变化(P>O．05)；在T2，D组MAP与HR明显低于C组，且差异有显著性(P

3、降低双腔支气管内插管的应激反应，降低双腔气管插管后肾上腺素水平和去甲肾上腺素水平，可在麻醉诱导时辅助应用。[关键词]插管法，气管内；应激；右美托咪啶EffectofDexmedetomidineonStressResponseofIntubationwithDouble-lumenEndObr0nchialtubeunderAnesthesiaInductionTANGLi(DepartmentofAnesthesiology，N0．363HospitalofPLA，Chengdu610041，China)[Abstract]【Objective】Toobserveth

4、eeffectofpre-injectionwithdexmedetomidinebeforeanesthesiain—ductiononstressresponseofintubationwithdouble-lumenendobronehialtube．[Methods]Atotalof59pa—tientsundergoinglungoresophagussurgeryundergeneralanesthesiainourhospitalwererandomlydividedin—tocontrolgroup(groupC，一29)andobservationgr

5、oup(groupD，n=30)．GroupDwasgivenanintrave—noustransfusionofdexmedetomidine0．6>g／kgbeforeanesthesiainduction，whilegroupCwasgivenanintra—venousinjectionofisovolumenormalsaline．Thenpatientsweregiventhetargetcontrolledinfusionofpropofolwithplasmatargetlevelof3／zg／mlandanintravenousinjectionof

6、sufentanil0．3~tg／kgandcisatracurium0．2mg／kg．Intubationwithdouble-lumenendobronchialtubewasperformed5minlater．Bloodsampleswerecol—lectedbeforeanesthesiainduction(To)andimmediatelyaftertrachealintubation(T2)。Highperformanceliquidchromatography(HPLC)wasusedtodetectplasmaepinephrine(E)andnor

7、epinephrine(NE)．Thechangesofmeanarterialpressure(MAP)andheartrate(HR)atTO，beforetrachealintubation(T])andTzwereobservedandrecorded．[ResultslTherewasnoobviouschangeinMAPandHRatTOandTIbetweengroupDandgroupC(P>O．05)．MAPandHRingroupDatT2wereobviouslylowerthanthoseingroupC．and