右美托咪定预防老年高血压患者全麻气管插管和拔管时心血管反应探究

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1、右美托咪定预防老年高血压患者全麻气管插管和拔管时心血管反应探究　　【摘要】目的探讨右美托咪定（dexmedetomidine，Dex）用于老年高血压患者全麻期间预防气管插管和拔管时心血管反应的临床效果及安全性。方法选择80例在本院行外科手术ASAⅡ～Ⅲ级伴高血压老年患者，随机双盲分为A（观察）组（n=40，气管插管前静注0.5μg/kgDex）和B（对照）组（n=40，气管插管前静注等量0.9%NS）。记录两组患者麻醉诱导前（T0）、诱导后5min（T1）、插管后即刻（T2）、插管后2min（T3）、拔管后即刻（T4）、拔管后2min（

2、T5）等时点的HR、SBP、DBP、SpO2的变化；观察两组麻醉时间、拔管时间、患者在PACU1h内意识状态、麻醉合并症及不良反应。结果两组患者麻醉时间、拔管时间差异无统计学意义。两组T1及A组其它时间点HR、SBP和DBP与T0比较明显降低（P0.05）。结论Dex可安全静脉泵注用于全麻老年高血压患者，能有效地预防气管插管和拔管时的心血管反应。【关键词】右美托咪定；老年患者；高血压；心血管反应；麻醉，全身Studyofdexmedetomidineonpreventionofthecardiovascularresponsedurin

3、gintubationand7extubationinoldagedpatientswithhypertensioningeneralanesthesiaZHENGChan，FENGYu-feng，SUNCai-hong.DepartmentofAnesthesiology，FirstAffiliatedHospitalofXiamenUniversity，Xiamen361003，China【Abstract】ObjectiveToinvestigatetheclinicaleffectsandsafetyofdexmedetomid

4、ine（Dex）onpreventionofthecardiovascularresponseduringintubationandextubationinoldagedpatientswithhypertensioningeneralanesthesia.Methods80electiveoldagedpatientswithhypertension，ASAgradeII～Ⅲ，undergoingsurgeryundergeneralanesthesiaweredouble-blindedrandomlyallocatedtotwog

5、roupswith40caseseach.GroupA（n=40）receivedDex0.5μg/kgandgroupB（n=40）receivedthesamevolumenormalsaline.HR，SBP，DBPwererecordedbeforeanesthesia（T0），afterinduction（T1），atthetimeofintubation（T2），3minafterintubation（T3），atthetimeofextubation（T4）and3minafterextubation（T5）.Thecom

6、plicationsandadversereactionsofanesthesiawererecordedduringeachoperation.anesthetictime、extubationtime7andpatients`consciousnessin1hourduringPACUwereobservedandrecorded.ResultsAnesthetictimeandextubationtimewerenotsignificantlydifferentinthetwogroups（P>0.05）.HR、SBP、DBPwe

7、refoundsignificantlylowerthanbaselineatthetimeofT1inbothgroupsandatothertimepointingroupA（P0.05）.ConclusionItissafetytopumpintravenousinjectionDexforoldagedpatientswithhypertensionundergoingsurgeryingeneralanesthesia.Itcanbeeffectiveinpreventingcardiovascularresponseduri

8、ngintubationandextubation.　　【Keywords】Dexmedetomidine；ElderlyPatients；Hypertension；Cardiovascularrespon