右美托咪定与地尔硫䓬减轻喉镜检查和气管插管升压反应的比较研究：一项双盲随机研究

A Comparative Study of Dexmedetomidine and Diltiazem for Attenuating Pressor Responses to Laryngoscopy and Endotracheal Intubation: A Double-blind, Randomized Study.

作者信息

Singh Raj Bahadur, Ojha Shivendu, Choubey Sanjay

机构信息

Department of Anaesthesiology, Narayan Medical College and Hospital, Sasaram, Bihar, India.

Department of Anaesthesiology, ELMCH, Lucknow, Uttar Pradesh, India.

出版信息

Anesth Essays Res. 2017 Oct-Dec;11(4):921-929. doi: 10.4103/aer.AER_101_17.

DOI:10.4103/aer.AER_101_17

PMID:29284850

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5735489/

Abstract

CONTEXT

Endotracheal intubation has been suggested to be one of the most invasive stimuli in anesthesia, particularly during induction and after tracheal intubation. The present study aims to evaluate the efficacy of dexmedetomidine as compared to diltiazem on hemodynamic response to laryngoscopy and intubation.

AIMS

To assess and compare the hemodynamic response of dexmedetomidine as compared to diltiazem in patients undergoing laryngoscopy and intubation and rate and type of side effects of the drugs if any.

SETTINGS AND DESIGN

This study design was a prospective, randomized, and double-blind trial.

SUBJECTS AND METHODS

The patients were randomly allocated into three groups: Group I (control), Group II (dexmedetomidine), and Group III (diltiazem) of 45 patients each. Group I ( = 45): 0.9% NaCl 10 ml was given to the patients over 10 min before intubation in Group I (control). Group II ( = 45): injection dexmedetomidine (0.5 μg/kg) in 10 ml normal saline was given to the patients over 10 min before intubation. Group III ( = 45): injection diltiazem (0.3 mg/kg) in 10 ml normal saline was given to the patients over 10 min before intubation.

STATISTICAL ANALYSIS USED

The data so collected were subjected to statistical analysis using Statistical Package for the Social Sciences version 15.0.

RESULTS

Mean percentage increase in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) following intubation was 17.90%, 19.96%, and 19.04%, respectively, in control group, 9.04%, 6.32%, and 7.53%, respectively, in dexmedetomidine group, and 12.30%, 10.32%, and 11.14%, respectively, in diltiazem groups. Statistically, there was a significant difference in postintubation SBP, DBP, and MAP of the three groups ( < 0.001). Dexmedetomidine at a dose of 0.5 μg/kg showed to have a better attenuation of pressor response as compared to diltiazem at a dose of 0.3 μg/kg.

CONCLUSIONS

Both dexmedetomidine and diltiazem were safe and effective in attenuating the hemodynamic response following laryngoscopy and endotracheal intubation; however, between two trial drugs, dexmedetomidine had a better response.

摘要

背景

气管插管被认为是麻醉中最具侵入性的刺激之一，尤其是在诱导期和气管插管后。本研究旨在评估右美托咪定与地尔硫䓬相比，对喉镜检查和插管时血流动力学反应的疗效。

目的

评估并比较右美托咪定与地尔硫䓬在接受喉镜检查和插管患者中的血流动力学反应，以及药物的副作用发生率和类型（如有）。

设置与设计

本研究设计为前瞻性随机双盲试验。

研究对象与方法

将患者随机分为三组：每组45例，第一组（对照组）、第二组（右美托咪定组）和第三组（地尔硫䓬组）。第一组（n = 45）：在插管前10分钟内给第一组（对照组）患者静脉注射10ml 0.9%氯化钠溶液。第二组（n = 45）：在插管前10分钟内给患者静脉注射10ml生理盐水稀释的右美托咪定注射液（0.5μg/kg）。第三组（n = 45）：在插管前10分钟内给患者静脉注射10ml生理盐水稀释的地尔硫䓬注射液（0.3mg/kg）。

统计分析方法

所收集的数据采用社会科学统计软件包1统计分析。

结果

对照组插管后收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP）的平均升高百分比分别为17.90%、19.96%和19.04%，右美托咪定组分别为9.04%、6.32%和7.53%，地尔硫䓬组分别为12.30%、10.32%和11.14%。统计学上，三组插管后的SBP、DBP和MAP存在显著差异（P < 0.001）。与0.3μg/kg剂量的地尔硫䓬相比，0.5μg/kg剂量的右美托咪定对升压反应的抑制作用更好。