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右美托咪定给药对接受脊髓麻醉的糖尿病患者术后血糖水平的影响:一项初步研究。

The Effects of Dexmedetomidine Administration on Postoperative Blood Glucose Levels in Diabetes Mellitus Patients Undergoing Spinal Anesthesia: A Pilot Study.

作者信息

Hui Yun So, Suk Choi Yun

机构信息

Department of Anesthesiology and Pain Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea.

出版信息

Anesth Pain Med. 2016 Sep 26;6(6):e40483. doi: 10.5812/aapm.40483. eCollection 2016 Dec.

Abstract

BACKGROUND

Dexmedetomidine (DEX) is an α2-adrenergic receptor agonist with sedative and sympatholytic effects. It inhibits the stress response and insulin secretion. Therefore, postoperative changes to blood glucose levels were investigated when DEX was intraoperatively infused for sedation purposes in diabetic patients under spinal anesthesia.

METHODS

Twenty diabetic patients were randomly allocated to two groups (n = 10). Group A patients were infused with DEX at a dose of 0.4 - 0.8 μg/kg/hour and group B (control) patients were infused with the same volume of normal saline. The blood glucose levels were measured preoperatively and at 1, 3, 6, 12, and 24 hours postoperatively.

RESULTS

There was no statistically significant difference between the blood glucose levels in groups A and B up to 24 hours postoperatively (P = 0.088). A statistically significant difference in the blood glucose level was not demonstrated 24 hours after surgery in comparison with the baseline level in Group A. The blood glucose level significantly decreased at three hours in group B in comparison with the level at baseline (P = 0.007) and increased at 24 hours (P = 0.037).

CONCLUSIONS

An intraoperative DEX infusion maintains blood glucose levels at a constant level relative to baseline in diabetic patients within 24 hours postoperatively. The frequency of hyperglycemia was low in group A in the perioperative period compared with that in the control group (group B).

摘要

背景

右美托咪定(DEX)是一种具有镇静和抗交感神经作用的α2肾上腺素能受体激动剂。它可抑制应激反应和胰岛素分泌。因此,本研究探讨了在脊髓麻醉下的糖尿病患者术中输注DEX进行镇静时,术后血糖水平的变化。

方法

将20例糖尿病患者随机分为两组(n = 10)。A组患者以0.4 - 0.8μg/kg/小时的剂量输注DEX,B组(对照组)患者输注相同体积的生理盐水。于术前及术后1、3、6、12和24小时测量血糖水平。

结果

术后24小时内,A组和B组的血糖水平无统计学显著差异(P = 0.088)。与基线水平相比,A组术后24小时的血糖水平无统计学显著差异。与基线水平相比,B组在术后3小时血糖水平显著降低(P = 0.007),在24小时时升高(P = 0.037)。

结论

术中输注DEX可使糖尿病患者术后24小时内的血糖水平相对于基线保持恒定。与对照组(B组)相比,A组围手术期高血糖的发生率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c18b/5560631/52a4599f691c/aapm-06-06-40483-i001.jpg

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