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静脉注射右美托咪定对腹腔镜胆囊切除术气腹期间血流动力学反应的影响。

Effects of Intravenous Dexmedetomidine on Hemodynamic Responses to Pneumoperitoneum During Laparoscopic Cholecystectomy.

机构信息

Department of Anaesthesiology, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.

Department of Anaesthesiology, Anandaban Hospital, The Leprosy Mission Nepal, Lele, Lalitpur, Nepal.

出版信息

Asian J Anesthesiol. 2023 Jun 1;61(2):71-80. doi: 10.6859/aja.202306_61(2).0004. Epub 2023 Jul 31.

Abstract

BACKGROUND

Dexmedetomidine is a potent α_2 agonist which has been used for blunting the stress responses during critical events such as laryngoscopy, endotracheal intubation, pneumoperitoneum creation, and extubation. The purpose of this study was to see the efficacy of intravenously administered dexmedetomidine at a dose of 0.5 mcg/kg in attenuating the hemodynamic responses due to pneumoperitoneum during laparoscopic cholecystectomy under general anesthesia.

METHODS

Sixty patients, ASA-PS class I (American Society of Anesthesiologist physical status class I), aged between 18 and 60 years, of either sex with weight ranging from 50 to 80 kg, scheduled for laparoscopic cholecystectomy were randomized into two groups (groups A and B) in a double-blinded fashion. Both groups were pre-medicated with an injection glycopyrrolate. Group A received 100 mL normal saline (NS) over 10 minutes while group B received dexmedetomidine 0.5 mcg/kg diluted in 100 mL NS over 10 minutes before induction of general anesthesia. Heart rate, systolic, diastolic, and mean arterial pressures were noted.

RESULTS

Following pneumoperitoneum, there was no statistically significant difference in the hemodynamic parameters between the two groups (P > 0.05).

CONCLUSION

Administration of dexmedetomidine at a dose of 0.5 mcg/kg before induction did not blunt the hemodynamic responses to pneumoperitoneum during laparoscopic cholecystectomy.

摘要

背景

右美托咪定是一种强效的 α_2 激动剂,已被用于减轻喉镜检查、气管插管、气腹创建和拔管等关键事件中的应激反应。本研究的目的是观察在全身麻醉下进行腹腔镜胆囊切除术时,静脉给予 0.5mcg/kg 右美托咪定剂量对减轻气腹引起的血流动力学反应的效果。

方法

60 名 ASA-PS 分级 I(美国麻醉医师协会身体状况分级 I)、年龄在 18 至 60 岁之间、性别不限、体重在 50 至 80 公斤之间的患者,随机分为两组(A 组和 B 组),采用双盲法。两组均预先给予注射用硫酸阿托品。A 组在诱导全身麻醉前 10 分钟内输注 100ml 生理盐水(NS),B 组输注 0.5mcg/kg 右美托咪定稀释于 100ml NS 中 10 分钟。记录心率、收缩压、舒张压和平均动脉压。

结果

气腹后,两组患者的血流动力学参数无统计学差异(P>0.05)。

结论

在诱导前给予 0.5mcg/kg 右美托咪定剂量并不能减轻腹腔镜胆囊切除术中气腹引起的血流动力学反应。

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