Department of Anaesthesiology and Pain Medicine, and Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Anaesthesia. 2015 Sep;70(9):1052-9. doi: 10.1111/anae.13084. Epub 2015 Apr 28.
The purpose of this study was to investigate the effects of dexmedetomidine on biventricular systolic and diastolic function using transoesophageal echocardiography. Cardiac function was assessed in 30 healthy patients who received total intravenous anaesthesia with propofol and remifentanil. The echocardiographic examinations were performed just before and 20, 40 and 60 min after dexmedetomidine or saline administration. Patients who received dexmedetomidine, compared with saline after 20 min, had a lower mean (SD) heart rate (56.7 (5.2) vs. 67.1 (7.1) beats.min(-1) ), higher systolic blood pressure (125.7 (18.9) vs. 109 (7.9) mmHg), and lower cardiac output (2.9 (0.5) vs. 3.7 (1.0) l.min(-1) ), respectively (all p < 0.05). In contrast, no changes were observed in biventricular systolic and diastolic indices in either group, and there were no inter-group differences at any time point. Dexmedetomidine, as an adjuvant to total intravenous anaesthesia, does not impair biventricular systolic and diastolic function in healthy patients, but decreases cardiac output by reducing heart rate.
本研究旨在通过经食管超声心动图研究右美托咪定对双心室收缩和舒张功能的影响。 对接受异丙酚和瑞芬太尼全静脉麻醉的 30 例健康患者进行心功能评估。 在给予右美托咪定或生理盐水前以及给予后 20、40 和 60 分钟进行超声心动图检查。 与给予生理盐水的患者相比,给予右美托咪定的患者在 20 分钟后心率(56.7(5.2)与 67.1(7.1)次/分钟)、收缩压(125.7(18.9)与 109(7.9)mmHg)和心输出量(2.9(0.5)与 3.7(1.0)l/min)均降低(均 P<0.05)。 相比之下,两组的双心室收缩和舒张指数均无变化,并且任何时间点两组间均无差异。 右美托咪定作为全静脉麻醉的辅助药物,不会损害健康患者的双心室收缩和舒张功能,但通过降低心率会降低心输出量。