Ke Jinyuan, Pen Xiaohong
Department of Anesthesiology, Wuhan Puai Hospital, Wuhan, 430034, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 May;27(10):478-80.
To observe the variance of blood pressure (BP) after controlled hypotension in endoscopic sinus surgery with dexmedetomidine.
Sixty patients undergoing elective endoscopic sinus surgery were randomly assigned to receive dexmedetomidine (Group D) or physiological saline (Group S). For the two groups, after the same induction of anesthesia procedure, Group D were injected with dexmedetomidine with 0.8 microg/kg of priming dose in 10 min and 0.5 microg/(kg x h) of maintenance dose i. v. drip for 30 min. The Group S were injected with physiological saline in the dose the same as Group D. The measurement of the mean aortic pressure(MAP), heart rate (HR) and the colouration of the Nasal packing material and exudation were taken at the end of the surgery (T1), at the time of extubation (T2), 10 min after extubation (T3), 30 min after extubation (T4), 2 h after extubation (T5), and 4 h after extubation (T6).
The MAP and HR of Group S at the points T2-T6 were significantly higher compared with those at the point T1 (P < 0.05). The MAP and HR of Group D at each time point did not change significantly (P > 0.05). The MAP and HR of Group S at each time point were higher compared with Group D (P < 0.05). The number of cases with postoperative nasal exudate in Group S was significantly more than in Group D (27:18) (P < 0.05).
The perioperative dexmedetomidine medication can significantly reduce fluctuations in BP in endoscopic sinus surgery, so that to stable hemodynamics and reduce nasal bleeding.
观察右美托咪定用于鼻内镜鼻窦手术控制性低血压后的血压变化。
将60例行择期鼻内镜鼻窦手术的患者随机分为右美托咪定组(D组)和生理盐水组(S组)。两组在相同的麻醉诱导程序后,D组于10分钟内静脉注射负荷剂量0.8μg/kg的右美托咪定,然后以0.5μg/(kg·h)的维持剂量静脉滴注30分钟。S组注射与D组相同剂量的生理盐水。分别于手术结束时(T1)、拔管时(T2)、拔管后10分钟(T3)、拔管后30分钟(T4)、拔管后2小时(T5)和拔管后4小时(T6)测量平均主动脉压(MAP)、心率(HR)以及鼻填塞物的渗血情况。
S组在T2 - T6各时间点的MAP和HR均显著高于T1时(P < 0.05)。D组各时间点的MAP和HR无明显变化(P > 0.05)。S组各时间点的MAP和HR均高于D组(P < 0.05)。S组术后鼻腔渗血的病例数显著多于D组(27∶18)(P < 0.05)。
围手术期应用右美托咪定可显著降低鼻内镜鼻窦手术中血压的波动,从而稳定血流动力学并减少鼻出血。