右旋美托咪定在静吸复合全身麻醉下鼻内镜手术控制性降压中的效果观察
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- 论文作者：董万超 ; 李伟伟
- 年：2017
- 作者机构：许昌市中心医院麻醉科;
- 论文关键词：右美托咪定 ; 硝酸甘油 ; 复合麻醉 ; 鼻内镜手术 ; 控制性降压
- 英文论文关键词：Dexmedetomidine ; Nitroglycerin ; Combined anesthesia ; Endoscopic sinus surgery ; Controlled hypotension
- 会议召开时间：2017-05-26
- 会议录名称：2017年《中国组织化学与细胞化学杂志》临床研讨会论文集
- 语种：中文
- 分类号：R614
- 学会代码：ZHXB
- 会议名称：2017年《中国组织化学与细胞化学杂志》临床研讨会
- 会议地点：中国湖北武汉
- 主办单位：《中国组织化学与细胞化学杂志》社有限公司
- 学会名称：《中国组织化学与细胞化学杂志》社有限公司
- 页数：2
- 文件大小：240k
- 原文格式：O
- 会议级别：全国
摘要
目的:探讨右美托咪定在静吸复合全麻下鼻内镜手术控制性降压中的安全性、有效性。方法:择期接受静吸复合全麻下鼻内镜手术的患者80例,按照计算机生成的随机序列分为2组:右美托咪定组(D组)和硝酸甘油组(N组)。术中维持患者的平均动脉压(MAP)位于60-70mmHg(1mmHg=0.133kPa)。评价手术开始后5min(T_1)、15min(T_2)、45min(T_3)时刻的术野质量,记录T_1、T_2、T_3时刻以及苏醒期拔管即刻(T_4)患者的心率(HR)、平均动脉压(MAP)、术中总出血量、尿量,不良事件发生情况。结果:与N组相比,D组患者的术野质量评分(SSFQ)升高(P<0.05);T_1、T_2、T_3时刻HR降低(P<0.05),T_4时刻D组患者的血压、心率波动较小(P<0.05)。与N组相比,D组患者出血量较少(P<0.05),尿量较多(P<0.05)。结论:右美托咪定可安全用于静吸复合全麻下鼻内镜手术的术中控制性降压。
Objective:To evaluate clinical effect of dexmedetomide on controlled hypotension under combined anesthesia during endoscopic sinus surgery.Methods:Eighty patients subjected to combined anesthesia were divided into 2 groups:dexmedetomidine group(group D) and nitroglycerin group(group N).Target MAP was 60-70 mmHg(ImmHg-0.133 kPa).The quality of the surgical field was assessed and the HR、MAP were recorded 5min(T_1)、15min(T_2)、45min(T_3) after the surgery.Amount of bleeding and urine volume were also recorded.Results:Compared with Group N,the quality of the surgical field was better(P< 0.05),HR at T_1、T_2、T_3 time points were lower in Group D(P < 0.05).Compared with Group N,total amount of bleeding was fewer and amount of urine volume was more in Group D(P<0.05).Conclusions:Induced hypotension by dexmedetomidine is feasible and safe in the functional endoscopic sinus surgery.
Objective:To evaluate clinical effect of dexmedetomide on controlled hypotension under combined anesthesia during endoscopic sinus surgery.Methods:Eighty patients subjected to combined anesthesia were divided into 2 groups:dexmedetomidine group(group D) and nitroglycerin group(group N).Target MAP was 60-70 mmHg(ImmHg-0.133 kPa).The quality of the surgical field was assessed and the HR、MAP were recorded 5min(T_1)、15min(T_2)、45min(T_3) after the surgery.Amount of bleeding and urine volume were also recorded.Results:Compared with Group N,the quality of the surgical field was better(P< 0.05),HR at T_1、T_2、T_3 time points were lower in Group D(P < 0.05).Compared with Group N,total amount of bleeding was fewer and amount of urine volume was more in Group D(P<0.05).Conclusions:Induced hypotension by dexmedetomidine is feasible and safe in the functional endoscopic sinus surgery.
引文
[1]刘莹.右美托咪定在麻醉中的应用进展.临床军医杂志,2015,43(6):656-657.
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[3]张国兴,蔡俊赢.右美托咪定用于呼吸睡眠暂停综合征手术后苏醒期患者镇静的研究[J].实用临床医学,2013,14(2):57-59.
[4]Snapir A,Posti J,Kentala E,et al.Effects of low and high plasma concentrations of dexmedetomidine on myocardial perfusion and cardiac function in healthy male subjects[J].Anesthesiology.2006,105(5):902-910.
[5]Sanders R D,Xu J,Shu Y,et al.Dexmedetomidine attenuates isofluraneinduced neurocognitive impairment in neonatal rats[J].Anesthesiology2009,110(5):1077-1085.
[2]罗恒茂,裴春明.鼻内镜手术中控制性降压麻醉后动脉压、心率与术野出血关系[J].耳鼻咽喉一头颈外科,2003,10(6):347-348.
[3]张国兴,蔡俊赢.右美托咪定用于呼吸睡眠暂停综合征手术后苏醒期患者镇静的研究[J].实用临床医学,2013,14(2):57-59.
[4]Snapir A,Posti J,Kentala E,et al.Effects of low and high plasma concentrations of dexmedetomidine on myocardial perfusion and cardiac function in healthy male subjects[J].Anesthesiology.2006,105(5):902-910.
[5]Sanders R D,Xu J,Shu Y,et al.Dexmedetomidine attenuates isofluraneinduced neurocognitive impairment in neonatal rats[J].Anesthesiology2009,110(5):1077-1085.