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右美托咪定推注剂量对全身麻醉下手术患者异氟烷消耗量的影响。

Effect of dexmedetomidine bolus dose on isoflurane consumption in surgical patients under general anesthesia.

作者信息

Muniyappa Reshma B, Rajappa Geetha C, Govindswamy Suresh, Thamanna Prathima P

机构信息

Department of Anesthesiology, M.S. Ramaiah Medical College, Bengaluru, Karnataka, India.

出版信息

Anesth Essays Res. 2016 Sep-Dec;10(3):649-654. doi: 10.4103/0259-1162.191122.

Abstract

BACKGROUND AND OBJECTIVE

Various adjuvants have been introduced to decrease the dose of volatile agents and their side effects. Dexmedetomidine a potent alpha-2 adrenoreceptor agonist is one such agent. Our objective is to assess the effect of preanesthetic dexmedetomidine on isoflurane consumption and its effect on intraoperative hemodynamic stability and recovery profile.

SETTING AND DESIGN

This prospective, randomized controlled, double-blind study was done in a tertiary care hospital.

MATERIALS AND METHODS

One hundred patients were randomly allocated into two groups. Group 1 received saline infusion and Group 2 received dexmedetomidine infusion in a dose of 1 μg/kg over 10 min given 15 min before induction. Vital parameters and bispectral index (BIS) values were noted throughout the surgery. Patients were induced and intubated as per the standard protocol and maintained with NO: O = 1:1 mixture at 2 L/min and isoflurane concentration adjusted to achieve BIS values of 45-60. Demographic profile, hemodynamic variables, total isoflurane consumption, and recovery profile data were collected.

STATISTICS

Independent -test and Mann-Whitney U-test were used to compare the average anesthetic consumption, hemodynamics, and recovery profile between two groups.

RESULTS

End-tidal concentration and total isoflurane consumption in Group 2 were 0.56 ± 0.11 and 10.69 ± 3.01 mL, respectively, with < 0.001 which was statistically significant compared to Group 1 which were 0.76 ± 0.14 and 13.76 ± 3.84 mL. Postintubation and intraoperative mean arterial pressure values were significantly lower in dexmedetomidine group with < 0.001.

CONCLUSION

Preanesthetic bolus dose of dexmedetomidine is a useful adjuvant to reduce isoflurane consumption.

摘要

背景与目的

已引入多种佐剂以降低挥发性麻醉剂的剂量及其副作用。右美托咪定是一种强效的α-2肾上腺素能受体激动剂,就是这样一种药物。我们的目的是评估麻醉前使用右美托咪定对异氟烷消耗量的影响及其对术中血流动力学稳定性和恢复情况的影响。

设置与设计

这项前瞻性、随机对照、双盲研究在一家三级护理医院进行。

材料与方法

100例患者被随机分为两组。第1组接受生理盐水输注,第2组在诱导前15分钟接受剂量为1μg/kg的右美托咪定输注,持续10分钟。在整个手术过程中记录生命体征参数和脑电双频指数(BIS)值。患者按照标准方案进行诱导和插管,并以2L/min的一氧化二氮:氧气 = 1:1混合气体维持,调整异氟烷浓度以达到45 - 60的BIS值。收集人口统计学资料、血流动力学变量、异氟烷总消耗量和恢复情况数据。

统计学方法

采用独立样本t检验和曼 - 惠特尼U检验比较两组之间的平均麻醉消耗量、血流动力学和恢复情况。

结果

第2组的呼气末浓度和异氟烷总消耗量分别为0.56±0.11和10.69±3.01mL(P<0.001),与第1组的0.76±0.14和13.76±3.84mL相比具有统计学意义。右美托咪定组插管后和术中平均动脉压值显著更低(P<0.001)。

结论

麻醉前给予右美托咪定推注剂量是减少异氟烷消耗量的一种有用佐剂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/959b/5062203/c483b8690f1f/AER-10-649-g002.jpg

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