Talke P, Chen R, Thomas B, Aggarwall A, Gottlieb A, Thorborg P, Heard S, Cheung A, Son S L, Kallio A
Departments of Anesthesia, University of California, San Francisco, CA 94143-0648, USA.
Anesth Analg. 2000 Apr;90(4):834-9. doi: 10.1097/00000539-200004000-00011.
We tested dexmedetomidine, an alpha(2) agonist that decreases heart rate, blood pressure, and plasma norepinephrine concentration, for its ability to attenuate stress responses during emergence from anesthesia after major vascular operations. Patients scheduled for vascular surgery received either dexmedetomidine (n = 22) or placebo (n = 19) IV beginning 20 min before the induction of anesthesia and continuing until 48 h after the end of surgery. All patients received standardized anesthesia. Heart rate and arterial blood pressure were kept within predetermined limits by varying anesthetic level and using vasoactive medications. Heart rate, arterial blood pressure, and inhaled anesthetic concentration were monitored continuously; additional measurements included plasma and urine catecholamines. During emergence from anesthesia, heart rate was slower with dexmedetomidine (73 +/- 11 bpm) than placebo (83 +/- 20 bpm) (P = 0.006), and the percentage of time the heart rate was within the predetermined hemodynamic limits was more frequent with dexmedetomidine (P < 0.05). Plasma norepinephrine levels increased only in the placebo group and were significantly lower for the dexmedetomidine group during the immediate postoperative period (P = 0.0002). We conclude that dexmedetomidine attenuates increases in heart rate and plasma norepinephrine concentrations during emergence from anesthesia.
The alpha(2) agonist, dexmedetomidine, attenuates increases in heart rate and plasma norepinephrine concentrations during emergence from anesthesia in vascular surgery patients.
我们测试了右美托咪定，一种能降低心率、血压和血浆去甲肾上腺素浓度的α₂激动剂，观察其在大血管手术后麻醉苏醒期间减轻应激反应的能力。计划进行血管手术的患者在麻醉诱导前20分钟开始静脉输注右美托咪定（n = 22）或安慰剂（n = 19），并持续至手术结束后48小时。所有患者均接受标准化麻醉。通过改变麻醉水平和使用血管活性药物将心率和动脉血压维持在预定范围内。持续监测心率、动脉血压和吸入麻醉剂浓度；额外的测量包括血浆和尿儿茶酚胺。在麻醉苏醒期间，右美托咪定组的心率（73±11次/分钟）比安慰剂组（83±20次/分钟）慢（P = 0.006），并且右美托咪定组心率在预定血流动力学范围内的时间百分比更高（P < 0.05）。仅安慰剂组的血浆去甲肾上腺素水平升高，术后即刻右美托咪定组的血浆去甲肾上腺素水平显著低于安慰剂组（P = 0.0002）。我们得出结论，右美托咪定可减轻麻醉苏醒期间心率和血浆去甲肾上腺素浓度的升高。
α₂激动剂右美托咪定可减轻血管手术患者麻醉苏醒期间心率和血浆去甲肾上腺素浓度的升高。
