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一项关于全麻下功能性鼻内镜鼻窦手术中预防性口服可乐定对术中血流动力学及手术视野质量影响的研究。

A Study of the Effect of Pre-emptive Oral Clonidine on Intraoperative Haemodynamics and Surgical Field Quality During Functional Endoscopic Sinus Surgery Under General Anaesthesia.

作者信息

Khandelwal Kapil, Sen Jayashree

机构信息

Department of Anaesthesia, Jawaharlal Nehru Medical College (Datta Meghe Institute of Higher Education & Research), Wardha, IND.

出版信息

Cureus. 2023 Apr 21;15(4):e37918. doi: 10.7759/cureus.37918. eCollection 2023 Apr.

Abstract

Introduction For endoscopic sinus surgery for rhinosinusitis, pre-emptive Alpha 2 agonist clonidine has been used to reduce sympathetic output, which lowers blood pressure and consequently surgical bleeding. The aim of this study was to analyze the effects of oral clonidine premedication in patients undergoing functional endoscopic sinus surgery. Methods This study was performed between December 2020 to November 2022 among two groups of 30 patients each: clonidine (200 μgm oral) and placebo. Parameters were recorded at baseline, 60 mins after administering the drugs, at induction, and at minutes five, 10, 20, 30, 45, 60, 75, 105, and 120. Six-point average category scale for bleeding was studied. IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States) was used for statistical analysis, and p < 0.05 was considered significant.  Results Demographic criteria were statistically non-significant. Heart rate (HR) and mean arterial pressure (MAP) were statistically non-significant at baseline and the 120th min mark, and were significant at other time intervals. The blood loss grading was less in the clonidine group, and the difference was found to be statistically significant (P < 0.001). Conclusion Pre-emptive oral clonidine 200 mcg 60 min prior to induction was found to reduce surgical bleeding by controlling haemodynamics.

摘要

引言 对于鼻窦炎的鼻内镜鼻窦手术,已使用预防性α2激动剂可乐定来降低交感神经输出,从而降低血压并减少手术出血。本研究的目的是分析口服可乐定术前用药对接受功能性鼻内镜鼻窦手术患者的影响。

方法 本研究于2020年12月至2022年11月在两组各30例患者中进行:可乐定组(口服200μg)和安慰剂组。在基线、给药后60分钟、诱导时以及第5、10、20、30、45、60、75、105和120分钟记录参数。研究了六点平均出血分类量表。使用IBM SPSS Statistics for Windows,版本20.0(2011年发布;IBM公司,美国纽约州阿蒙克)进行统计分析,p<0.05被认为具有统计学意义。

结果 人口统计学标准在统计学上无显著差异。心率(HR)和平均动脉压(MAP)在基线和第120分钟时在统计学上无显著差异,而在其他时间间隔有显著差异。可乐定组的失血量分级较低,差异具有统计学意义(P<0.001)。

结论 发现在诱导前60分钟口服200μg预防性可乐定可通过控制血流动力学来减少手术出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e85/10202669/153bc4807841/cureus-0015-00000037918-i01.jpg

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