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两剂右美托咪定对减轻心血管反应及呼吸道拔管安全性的疗效

Efficacy of two doses of dexmedetomidine on attenuating cardiovascular response and safety of respiratory tract to extubation.

作者信息

Shetabi Hamidreza, Karimian Shima

机构信息

Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Cardiovasc Thorac Res. 2023;15(2):73-79. doi: 10.34172/jcvtr.2023.31647. Epub 2023 Jun 29.

Abstract

INTRODUCTION

Extubation can be associated with an adverse hemodynamic or respiratory response, which may be serious in cardiovascular written or in the elderly. The present study was conducted with the aim of investigating the effect of two different doses of dexmedetomidine in the prevention of extubation complications.

METHODS

This randomized clinical trial was conducted in Isfahan in 2020-2021 on 174 patients undergoing elective surgery. Patients were randomly divided into 3 groups receiving dexmedetomidine 1 μg/kg (D1), dexmedetomidine 0.5 μg/kg (D2), and normal saline (S). Hemodynamic variables include heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and peripheral blood oxygen saturation (Spo2) was measured and recorded before removing the endotracheal tube and at 1, 3, 5 and 10 minutes after extubation. Also, airway responses to extubation such as cough, hoarseness, and laryngospasm were investigated.

RESULTS

SBP, MAP, and HR in the D1 group were significantly lower than in other groups. In the D2 group, these measurements were lower than the control group at 3, 5, and 10 minutes after extubation (<0.05 for all). In placebo group, SBP, MAP, and HR increased significantly after extubation (=0.01). In group D1, cough (=0.007) and its intensity (=0.013), nausea and vomiting (=0.04) and chills (=0.001) were less than in other groups.

CONCLUSION

In the D1 group, attenuation of autonomic response to extubation was more than other groups and side effects were less than D2 group, and in both groups, these side effects were less than the saline group.

摘要

引言

拔管可能会伴有不良的血流动力学或呼吸反应,这在心血管疾病患者或老年人中可能较为严重。本研究旨在探讨两种不同剂量的右美托咪定在预防拔管并发症方面的效果。

方法

这项随机临床试验于2020年至2021年在伊斯法罕对174例行择期手术的患者进行。患者被随机分为3组,分别接受1μg/kg右美托咪定(D1组)、0.5μg/kg右美托咪定(D2组)和生理盐水(S组)。在拔除气管导管前以及拔管后1、3、5和10分钟测量并记录血流动力学变量,包括心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和外周血氧饱和度(Spo2)。此外,还研究了拔管时的气道反应,如咳嗽、声音嘶哑和喉痉挛。

结果

D1组的SBP、MAP和HR显著低于其他组。在D2组中,这些测量值在拔管后3、5和10分钟低于对照组(均P<0.05)。在安慰剂组中,拔管后SBP、MAP和HR显著升高(P=0.01)。在D1组中,咳嗽(P=0.007)及其强度(P=0.013)、恶心和呕吐(P=0.04)以及寒战(P=0.001)均少于其他组。

结论

在D1组中,对拔管的自主反应减弱程度大于其他组,且副作用少于D2组,两组的这些副作用均少于生理盐水组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2592/10466467/9453ed9e24a7/jcvtr-15-73-g001.jpg

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