右美托咪定用于老年患者全身麻醉拔管期时的气道和心血管反应的观察.pdf

《右美托咪定用于老年患者全身麻醉拔管期时的气道和心血管反应的观察.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、54ChineseJournalofClinicalMedicine，2014．Vo1．21，No．1中国临床医学2014年2月第21卷第1期论著右美托咪定用于老年患者全身麻醉拔管期时的气道和心血管反应的观察毛菇谢力顾仕贤王庆宝常胜和(东南大学附属南京江北人民医院麻醉科，江苏南京210048)摘要目的：探讨右关托咪定(dexmedetomidine，Dex)对老年患者全身麻醉拔管期气道和心血管反应的影响。方法：将5()例行胆囊切除术、ASAI～II级的老年患者随机分为Dex组(A组)和对照组(B组)，每组各25例。A组和B组于全身麻醉诱导时分别静脉泵注Dex和咪唑安定。观察并记录两组

2、患者于入室时(TI)、拔管前(T2)、拔管后1min(T3)、拔管后15min(T4)时的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(SpO)以及呛咳情况。结果：在T4时，A组患者SBP、DBP及HR明显低于B组(P<0．05)。A组拔管期呛咳等级为I+II级的患者占该组患者的88，明显高于B组(56)，P<0．05；A组中出现严重呛咳反应(III+IV级)的患者(12)显著少于B组(44)，差异有统计学意义(P<0．05)。结论：Dex可以减轻老年患者全身麻醉拔管时的气道和心血管反应。关键词右美托咪定；拔管；气道反应；心血管反应中图分类号R614文献标识码AE

3、ffectofDexmedetomidineduringTrachealExtubationinElderlyPatientsunderGeneralAnesthesiaMA0GuXIELiGUShixianWANGQingbaoCHANGShengheDepartmentofAnesthesi0l0gy，NanjingJiangbeiPeople~HospitalAffiliatedtoSoutheastUniversity，Nanjing210048，ChinaAbstract0bjective：Toinvestigatetheeffectofdexmedetomidineona

4、irwayandcardiovascularreactionsduringtrachealextubationinelderlypatientsundergeneralanesthesia．Methods!FiftyASAlorIIelderlypatientsaged60—75yearswhowereundergoinglaparoscopiccholecystectomywererandomlydividedintodexmedetomidinegroup(GroupA)andcontrolgroup(GroupB)，withtwenty-fivepatientsineachgr

5、oup．PatientsinGroupAwereadministeredwithdexmedetomidineatadoseof1fg／kgatthebeginningoftheoperation，whilethoseinGroupBwereadministeredwithmidazolamatadoseof150fg／kgviamicropumps．Thesystolicbloodpressure(SBP)，diastolicbloodpressure(DBP)，heartrate(HR)，pulseoxygensaturation(SpO2)andtheoccurrenceofc

6、oughwererecordedatthetimeofbaseline(T1)，duringextubation(T2)，1minuteafterextubation(T3)，15minuteafterextubation(T4)．Results：AtthetimeofT4，theSBP，DBPandHRinGroupAweresignifi—cantlylowerthanthoseinGroupB(P％0．05)．InGroupA，SBPandDBPatT2(P(0．叭)andT3(P<0．05)weresignificant—lyhigherthanthoseatT4，andHR

7、atT4wassignificantlylowerthanthatatT1，T2andT3(P<(】．05)．ThepercentageofpatientswhosecoughgradeswereIandIIduringtrachealextubationinGroupA(88)wassignificantlyhigherthanthatinGroupB(56)(P％005)；SeriouschokingcoughresponseinGroupAwasal