右美托咪定对高血压患者全身麻醉拔管期RPP和PRQ的影响.pdf

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1、临床麻醉学杂志2014年2月第3O卷第2期JClinAnesthesiol，February2014，Vo1．30，No．2·125·．临床研究．右美托咪定对高血压患者全身麻醉拔管期RPP和PRQ的影响戴双波古妙宁齐娟【摘要】目的探讨右美托咪定对高血压患者全身麻醉拔管期心率收缩压乘积(RPP)和血压心率比值(PRQ)的影响。方法择期高血压手术患者6O例，性别不限，年龄18~60岁，ASAI～Ⅲ级。采用随机数字表法，将患者随机均分为右美托咪定组(D组)和对照组(C组)。手术结束前3OminD组静脉注射右美托咪定0．5~g

2、／kg(大于10min)；C组静脉注射等剂量生理盐水。观察两组用药前、拔管前、拔管时，拔管后5、10min的HR、SBP、DBP、MAP。计算RPP和PRQ。结果与C组比较，D组患者SBP、MAP在拔管前、拔管时、拔管后5min，DBP在拔管时、拔管后5min明显降低，HR在拔管前、拔管时明显减慢(P<0．05)；D组患者RPP在拔管前、拔管时、拔管后5、10min均明显降低(P

3、的心血管反应及稳定血流动力学，降低RPP值。【关键词】高血压；右美托咪定；气管拔管；血流动力学；RPP；PRQEffectofdexmedetomidineonRPPandPRQduringextubationperiodaftergeneralanesthesiainpatientswithhypertensionDAIShuang-bo，GUMiao-ning，Q，Juan．DepartmentofAnesthesiology，NanfangHospital，SouthernMedicalUniversity，Gu

4、angzhou510515，ChinaCorrespondingauthor：GUMiao—M馏，Email：mzkgmn@263．net[Abstract]ObjectiveToobservetheeffectofdexmedetomidineonRPPandPRQduringextubationperiodaftergeneralanesthesiainpatientswithhypertension．MethodsSixtypatientswithhypertensionundergoingelectivesur

5、gery，aged18—6Oyearsold，ASAI—mlevel，wererandomlyassignedtoreceiveintravenousinfusionofeither0．5／,g／kgdexmedetomidine(groupD。一30)orsameamountofnormalsaline(groupC，=30)at30minutesbeforetheendofoperation．SBP，DBP，MAPandHRwererecordedbeforeinfusion，beforeextubation，ri

6、ghtbeforeextubation，and5and10minutesafterextubation．Rate-pressureproduct(RPP)，definedastheproductofSBPandHR，andpressure-ratequotient(PRQ)，definedasMAPdividedbyHR，arecalculatedatthesametimepoints．ResultsComparedwithgroupC，SBP，MAPdecreasedbeforeextubation，duringex

7、tubation，and5minutesafterextubation，DBPdecreasedduringextubation，and5minutesafterextubation，HRdecreasedbeforeextubation，duringextubationingroupA(P<0．05)，theRPPdecreasedbeforeextubation，duringextubation，5and10minutesafterextubation(P<0．05)．Therewerenosignificantd

8、ifferencesinPRQatalltimepoints．ConclusionIntravenousinfusionof0．5g／kgdexmedetomidineat30minutesbeforetheendofoperationcaneffectivelyreducecardiovascularresponsesoftra