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麻醉前单剂量右美托咪定对诱导、血流动力学及心血管参数的影响。

The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters.

作者信息

Basar Hülya, Akpinar Serpil, Doganci Nur, Buyukkocak Unase, Kaymak Cetin, Sert Ozgur, Apan Alpaslan

机构信息

Department of Anesthesiology and Reanimation, Ministry of Health, Ankara Training and Education Hospital, Ankara, Turkey.

出版信息

J Clin Anesth. 2008 Sep;20(6):431-6. doi: 10.1016/j.jclinane.2008.04.007.

Abstract

STUDY OBJECTIVES

To investigate the hemodynamic, cardiovascular, and recovery effects of dexmedetomidine used as a single preanesthetic dose.

DESIGN

Randomized, prospective, double-blind study.

SETTING

University Hospital of Kirikkale, Kirikkale, Turkey.

PATIENTS

40 ASA physical status I and II patients, aged 20 to 60 years, who were scheduled for elective cholecystectomy.

INTERVENTIONS

Patients were randomly divided into two groups to receive 0.5 microg kg(-1) dexmedetomidine (group D, n = 20) or saline solution (group C, n = 20). Anesthesia was induced with thiopental sodium and vecuronium, and anesthesia was maintained with 4% to 6% desflurane.

MEASUREMENTS

Mean arterial pressure (MAP), heart rate (HR), ejection fraction (EF), end-diastolic index (EDI), cardiac index (CI), and stroke volume index (SVI) were recorded at 10-minute intervals. The times for patients to "open eyes on verbal command" and postoperative Aldrete recovery scores were also recorded.

MAIN RESULTS

In group C, an increase in HR and MAP occurred after endotracheal intubation. In group D, HR significantly decreased after dexmedetomidine was given. The EDI, CI, SVI, and EF values were similar in groups D and C. The modified Aldrete recovery scores of patients in the recovery room were similar in groups C and D at the 15th minute.

CONCLUSIONS

A single dose of dexmedetomidine given before induction of anesthesia decreased thiopental requirements without serious hemodynamic effects or any effect on recovery time.

摘要

研究目的

探讨单次麻醉前剂量右美托咪定的血流动力学、心血管及恢复效应。

设计

随机、前瞻性、双盲研究。

地点

土耳其基尔卡莱基尔卡莱大学医院。

患者

40例年龄在20至60岁之间、ASA身体状况为I级和II级、计划行择期胆囊切除术的患者。

干预措施

患者被随机分为两组,分别接受0.5微克/千克(-1)右美托咪定(D组,n = 20)或生理盐水(C组,n = 20)。用硫喷妥钠和维库溴铵诱导麻醉,并用4%至6%地氟醚维持麻醉。

测量指标

每隔10分钟记录平均动脉压(MAP)、心率(HR)、射血分数(EF)、舒张末期指数(EDI)、心脏指数(CI)和每搏量指数(SVI)。还记录患者“对言语指令睁眼”的时间和术后Aldrete恢复评分。

主要结果

在C组中,气管插管后HR和MAP升高。在D组中,给予右美托咪定后HR显著降低。D组和C组的EDI、CI、SVI和EF值相似。在恢复室,C组和D组患者在第15分钟时的改良Aldrete恢复评分相似。

结论

麻醉诱导前给予单次剂量右美托咪定可降低硫喷妥钠需求量,且无严重血流动力学影响或对恢复时间无任何影响。

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