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口服可乐定预处理对喉镜检查和气管插管血流动力学反应的影响:一项临床试验

Effects of oral clonidine premedication on haemodynamic response to laryngoscopy and tracheal intubation: a clinical trial.

作者信息

Talebi H, Nourozi A, Fateh S, Mohammadzadeh A, Eghtesadi-Araghi P, Jabbari S, Kalantarian M

机构信息

Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran.

出版信息

Pak J Biol Sci. 2010 Dec 1;13(23):1146-50. doi: 10.3923/pjbs.2010.1146.1150.

Abstract

The objective of this study was to evaluate the efficacy of pre-anesthetic orally administration of clonidine on pulse rate and blood stress response to laryngoscopy and tracheal intubation. In a double-blinded, randomized study, 274 ASA I and II subjects with age of 18 to 45 years scheduled for elective surgery under general anesthesia were enrolled. They were randomly allocated to receive oral clonidine (0.2 mg) or placebo as premedication 90-120 min before surgery. All the patients received Succinylcholine (1.5 mg kg(-1)) after induction of anesthesia with Fentanyl (50 microg) and Thiopentone (5 mg kg(-1)). The anesthesia was maintained with halothane (1.5 Mac) in 50% mixture of N2O/O2. Heart rate and systolic blood pressure were recorded before, immediately after and then every 5 min after intubation until 20 min. The Clonidine group showed a significant superiority over placebo in the prevention of increase in systolic blood pressure as well as heart rate over the intubation. A significant difference was observed in both heart rate and systolic blood pressures were significantly higher in Control group at three subsequent measurements following intubation. The results of this study suggest that orally administered clonidine in preanesthetic period, provides more haemodynamic stability and attenuates the stress response to laryngoscopy and intubation.

摘要

本研究的目的是评估麻醉前口服可乐定对喉镜检查和气管插管时脉搏率及血压反应的疗效。在一项双盲、随机研究中,纳入了274例年龄在18至45岁、计划接受全身麻醉下择期手术的美国麻醉医师协会(ASA)I级和II级受试者。他们被随机分配在手术前90 - 120分钟接受口服可乐定(0.2毫克)或安慰剂作为术前用药。所有患者在使用芬太尼(50微克)和硫喷妥钠(5毫克/千克)诱导麻醉后接受琥珀酰胆碱(1.5毫克/千克)。麻醉维持采用含1.5最低肺泡有效浓度(MAC)氟烷的50%氧化亚氮/氧气混合气体。记录插管前、插管后即刻以及插管后每隔5分钟直至20分钟的心率和收缩压。可乐定组在预防插管期间收缩压及心率升高方面显示出比安慰剂组有显著优势。在插管后的随后三次测量中,对照组的心率和收缩压均显著更高。本研究结果表明,麻醉前口服可乐定可提供更好的血流动力学稳定性,并减轻对喉镜检查和插管的应激反应。

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