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腹腔镜胆囊切除术中不同剂量右美托咪定输注对血流动力学影响的比较分析:一项观察性研究

A Comparative Analysis of Dexmedetomidine Infusion Rates on Hemodynamic Responses During Laparoscopic Cholecystectomy: An Observational Study.

作者信息

Verma Rachna, Nadeem Amra, Bafila Narendra S, Gautam Sanni D, Kumar Deepak, Giri Manoj K

机构信息

Anaesthesiology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, IND.

Anaesthesiology, Dr. KNS Memorial Institute of Medical Sciences, Barabanki, IND.

出版信息

Cureus. 2024 Nov 26;16(11):e74538. doi: 10.7759/cureus.74538. eCollection 2024 Nov.

Abstract

Background Although laparoscopic surgery is becoming more common, its anesthetic management poses challenges due to hemodynamic fluctuations. Dexmedetomidine has shown promise in mitigating these responses. In this study, we compared the effects of three different infusion doses of dexmedetomidine (0.2 µg/kg/hour, 0.4 µg/kg/hour, and 0.6 µg/kg/hour) on hemodynamic responses at the time of laparoscopic cholecystectomy. Methodology An observational study was conducted among 90 adult patients undergoing laparoscopic cholecystectomy. Patients were divided into three groups, each receiving one of the three dexmedetomidine doses. Hemodynamic parameters (systolic and diastolic blood pressures, mean arterial pressure, etc.) were monitored at various time points throughout the procedure. Results All three dexmedetomidine doses effectively attenuated hemodynamic responses. The 0.4 µg/kg/hour dose demonstrated the most stable blood pressure control, with minimal fluctuations from baseline. The 0.6 µg/kg/hour dose consistently resulted in lower mean blood pressure values. Heart rate was also more stable in the 0.4 µg/kg/hour group, while the 0.6 µg/kg/hour group consistently maintained lower heart rates. Conclusions Dexmedetomidine is a valuable anesthetic adjuvant for laparoscopic cholecystectomy, with the 0.4 µg/kg/hour dose offering a favorable balance between hemodynamic stability and the potential risk of hypotension and bradycardia.

摘要

背景

尽管腹腔镜手术越来越普遍,但其麻醉管理因血流动力学波动而带来挑战。右美托咪定在减轻这些反应方面已显示出前景。在本研究中,我们比较了三种不同输注剂量的右美托咪定(0.2微克/千克/小时、0.4微克/千克/小时和0.6微克/千克/小时)对腹腔镜胆囊切除术时血流动力学反应的影响。

方法

对90例接受腹腔镜胆囊切除术的成年患者进行了一项观察性研究。患者被分为三组,每组接受三种右美托咪定剂量中的一种。在整个手术过程的不同时间点监测血流动力学参数(收缩压和舒张压、平均动脉压等)。

结果

所有三种右美托咪定剂量均有效减轻了血流动力学反应。0.4微克/千克/小时的剂量显示出最稳定的血压控制,与基线相比波动最小。0.6微克/千克/小时的剂量始终导致较低的平均血压值。0.4微克/千克/小时组的心率也更稳定,而0.6微克/千克/小时组始终保持较低的心率。

结论

右美托咪定是腹腔镜胆囊切除术的一种有价值的麻醉辅助药物,0.4微克/千克/小时的剂量在血流动力学稳定性与低血压和心动过缓的潜在风险之间提供了良好的平衡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8df0/11671647/e7c054ef84a5/cureus-0016-00000074538-i01.jpg

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