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山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (8): 81-.

• 临床医学 • 上一篇    下一篇

右美托咪啶对高血压患者开颅术麻醉的影响

周廷发1,唐贞申2   

  1. 1.临沂市人民医院麻醉科, 山东 临沂 276000;  2.山东大学附属省立医院麻醉科, 济南  250021
  • 收稿日期:2012-02-25 出版日期:2012-08-10 发布日期:2012-08-10
  • 通讯作者: 唐贞申(1968- ),男,博士,副主任医师,主要从事临床麻醉研究。 E-mail:ccmtzs68@163.com
  • 作者简介:周廷发(1966- ),男,硕士,副主任医师,主要从事临床麻醉研究。

Effect of dexmedetomidine on general anesthesia in
hypertensive patients undergoing craniectomy

ZHOU Ting-fa1, TANG Zhen-shen2   

  1. 1. Department of Anesthesiology, Linyi People′s Hospital, Linyi 276000, Shandong, China;
    2. Department of Anesthesiology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
  • Received:2012-02-25 Online:2012-08-10 Published:2012-08-10

摘要:

目的   探讨右美托咪啶对高血压患者枕后开颅面神经显微血管减压术麻醉用药以及麻醉苏醒的影响。方法   选择合并高血压病面神经显微减压术患者48例,随机分为两组,每组24例。研究组麻醉诱导前静脉微量泵入右美托咪啶负荷量(1μg/kg), 继以维持0.2~0.7μg /(kg·h);对照组则微量泵入相同剂量的生理盐水。两组术中控制血压,收缩压维持在术前基础值的70%~80%。两组麻醉诱导选用丙泊酚、芬太尼和维库溴铵。以丙泊酚和瑞芬太尼持续泵注维持麻醉,观察两组患者麻醉药泵注速度、麻醉苏醒时间及拔管时间。结果   研究组麻醉药泵注速度[丙泊酚(0.076±0.014)mg/(kg·min) vs (0.092±0.018)mg/(kg· min);瑞芬太尼(0.106±0.032)μg/(kg·min) vs (0.131±0.030)μg/(kg· min)]、麻醉苏醒时间[(5.2±2.1)min vs (9.3±2.4)min]及拔管时间[(5.3±2.4)min vs (10.3±3.2 )min]与对照组相比差异均有统计学意义(P均< 0.05)。结论   右美托咪啶用于高血压患者枕后开颅术可明显减少麻醉用药量,缩短麻醉苏醒时间,加快拔管。

关键词: 右美托咪定;高血压;面神经显微血管减压;开颅术;麻醉

Abstract:

Objective   To detect the effect of dexmedetomidine(DEX) on general anesthesia of hypertensive patients undergoing retromastoid craniectomy for microvascular decompression(MVD) of facial nerve. Methods   48 (ASA Ⅰ-Ⅱ) hemifacial spasm patients with hypertension undergoing retromastoid craniectomy for MVD of facial nerve under general anesthesia were randomly divided into two groups: the study group and the control group. Dexmedetomidine was injected with the load dosage (1μg/kg) before anesthesia, followed by the maintaining dosage [0.20.7μg/(kg·h)] during anesthesia in the study group. Sodium chloride injection was pumped in the control group. Anesthesia was maintained with propofol and remifentanil. During the surgery, systolic blood pressure (SBP) was maintained 70%-80% of the baseline value by titration of anesthetic drugs and/or nitroglycerin in both groups. The mean infusion rates of propofol and remifentanil, anesthesia recovery and extubation times were observed. Results   Compared with the control group, patients in the study group required lower normalized infusion rates of propofol [(0.076±0.014)mg/(kg·min) vs (0.092 ± 0.018)mg/(kg·min), P<0.05] and remifentanil [(0.106±0.032) vs (0.131±0.030)μg/(kg·min), P<0.05]. Anesthesia recovery times [(5.2±2.1)min vs (9.3±2.4)min] and extubation times [(5.3±2.4)min vs (10.3±3.2)min] were also significantly shorter than those in the control group (P< 0.05). Conclusion   Dexmedetomidine can effectively reduce the consumption of anesthetic drugs, shorten the recovery  times and hasten the extubation in the hypertensive patients during retromastoid craniectomy undergeneral anesthesia.

Key words: Dexmedetomidine;  Hypertension;  Microvascular decompression; Craniectomy;  General anesthesia

中图分类号: 

  • R614
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