中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2017, Vol. 46 ›› Issue (10): 913-916.doi: 10.12007/j.issn.0258‐4646.2017.10.012

• 论著 • 上一篇    下一篇

右美托咪定对肥胖患者苏醒期的影响

肖甄男1,龙波1,于砾淳2,白茹冰3   

  1. 1 中国医科大学附属盛京医院麻醉科,沈阳 110004;2 辽宁省肿瘤医院麻醉科,沈阳 110042;3 中国医科大学附属第四医院第四普通外科,沈阳 110032
  • 收稿日期:2017-01-09 出版日期:2017-10-30 发布日期:2017-10-16
  • 通讯作者: 龙波 E-mail:longbo_27@163.com
  • 作者简介:肖甄男(1988-),男,医师,硕士
  • 基金资助:
    辽宁省社会发展攻关计划(2012225021)

Effect of Dexmedetomidine on the Anesthesia Recovery Period in Obese Patients

XIAO Zhennan1,LONG Bo1,YU Lichun2,BAI Rubing3   

  1. 1 Department of Anesthesiology,Shengjing Hospital ,China Medical University,Shenyang 110004,China;2 Department of Anesthesiology,Liaoning Cancer Hospital & Insitute,Shenyang 110042,China;3 Department of Forensic Sursery,The Fourth Affiliated Hospital,China Medical University,She- nyang 110032,China
  • Received:2017-01-09 Online:2017-10-30 Published:2017-10-16

摘要: 目的 探讨右美托咪定0.4 μg?kg-1?h-1对肥胖患者腹腔镜手术苏醒期的影响。方法 选择择期行腹腔镜下Roux-en-Y吻合 术且体质量指数(BMI)≥30 kg/m2的患者30例,随机分为右美托咪定组(D组)和对照组(C组),每组15例。D组于手术开始时泵 注右美托咪定0.4 μg?kg-1?h-1,手术结束前30 min停止泵注;C组同时泵注等量的生理盐水。2组采用相同的麻醉诱导及维持方 案。记录患者各时点的心率(HR),平均动脉压(MBP),心率变异性指标:低频率(LF)、高频率(HF)、LF/HF,拔管时间,拔管时镇静 躁动评分(SAS),苏醒期躁动评级及不良事件的发生情况。结果 C组苏醒期HR、MBP及LF/HF均较基础值高,且均高于D组(P <0.05);C组在拔管前及拔管时LF均高于D组(P < 0.05);D组苏醒期MBP较基础值低(P < 0.05),且拔管时SAS、苏醒期躁动评级均低 于C组(P < 0.05);2组间HF及拔管时间无统计学差异(P > 0.05)。结论 给予肥胖患者术中泵注盐酸右美托咪定0.4μg?kg-1?h-1不 仅不延长苏醒拔管时间,还能提高苏醒期质量。

关键词: 右美托咪定, 肥胖, 心率变异性, 苏醒期

Abstract: Objective To explore the effect of intravenous dexmedetomidine(0.4μg?kg-1?h-1) on the recovery period in obese patients undergoing laparoscopic Roux-en-Y surgery. Methods Thirty patients(ASA ⅠtoⅡ,body mass index ≥30 kg/m2)presenting for laparo- scopic Roux-en-Y surgery under general anesthesia were randomly assigned 1∶1 to the dexmedetomidine group(group D)or control group(group C). Dexmedetomidine was infused at 0.4μg?kg-1?h-1 at the beginning of the operation and was discontinued 30 minutes before the end of the surgery in group D. Simultaneously,normal saline was infused at 0.4μg?kg-1?h-1 in group C. The two groups received the same method of nduction and maintenance anesthesia. The intraoperative variables measured included heart rate(HR),mean blood pressure(MBP),low frequency(LF),high frequency(HF),LF/HF ratio extubation time,Silverman-Andersen score(SAS)at the time of extubation, level of agitation during the recovery period,and adverse events. Results HR,MBP,and LF/HF of group C were higher than the baseline values and that of group D(P < 0.05)during the recovery period. LF was higher in group C those in group D(P < 0.05)during the recovery period. MBP was lower than the baseline values(P < 0.05)and SAS at the time of extubation and level of agitation during the anesthesia recovery period were lower in group D(P < 0.05)than in group C. There was no significant difference in HF and extubation time between the two groups(P > 0.05). Conclusion Infusion of dexmedetomidine during anesthesia in obese patients may improve the quality of emergence from anesthesia without increasing the duration of the anesthesia recovery period.

Key words: dexmedetomidine, obesity, heart rate variability, anesthesia recovery period

中图分类号: 

  • R614.2
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