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[小剂量可乐定对老年患者围手术期血流动力学及麻醉需求的影响]

[The effects of low dose clonidine on perioperative hemodynamics and anesthetic requirements in elderly patients].

作者信息

Masuda T, Kondo A, Akazawa T, Kitahata H, Nakahara T

机构信息

Department of Anesthesiology, Tokushima University School of Medicine.

出版信息

Masui. 1995 May;44(5):668-73.

PMID:7609294
Abstract

The effects of clonidine, alpha 2-adrenergic receptor agonist, on perioperative hemodynamics and anesthetic requirements were studied in randomized 20 elderly patients without hypertension (ASA I-II) scheduled for elective abdominal surgery under general anesthesia. The control group (n = 10) was premedicated with oral diazepam 0.1 mg.kg-1 90 min prior to arrival in the operating room. The clonidine group (n = 10), in addition, received clonidine approximately 2.5 micrograms.kg-1 orally at the same time. Anesthesia was induced with fentanyl 2 micrograms.kg-1 and thiamylal 4 mg.kg-1. Vecuronium 0.15 mg.kg-1 following 0.01 mg.kg-1 priming dose was used to facilitate endotracheal intubation. Anesthesia was maintained with isoflurane in 50% nitrous oxide-oxygen and supplementary fentanyl. Clonidine effectively attenuated the cardiovascular response associated with laryngoscopy and tracheal intubation. Intraoperative variability of heart rate was significantly lower in patients receiving clonidine compared with controls. No significant differences in the requirements of either isoflurane or narcotic supplementation were observed between the two groups. We conclude that a low dose clonidine is a useful adjunct in the management of elderly patients without producing side effects.

摘要

研究了α2-肾上腺素能受体激动剂可乐定对20例择期行全身麻醉下腹部手术的无高血压老年患者(美国麻醉医师协会分级I-II级)围手术期血流动力学及麻醉需求的影响。对照组(n = 10)在进入手术室前90分钟口服地西泮0.1 mg·kg-1进行术前用药。可乐定组(n = 10)在此基础上,同时口服约2.5微克·kg-1可乐定。麻醉诱导采用2微克·kg-1芬太尼和4毫克·kg-1硫喷妥钠。给予0.01 mg·kg-1的预充剂量后,使用0.15 mg·kg-1维库溴铵辅助气管插管。麻醉维持采用异氟烷吸入50%氧化亚氮-氧气,并补充芬太尼。可乐定有效减弱了与喉镜检查和气管插管相关的心血管反应。与对照组相比,接受可乐定治疗的患者术中心率变异性显著降低。两组间异氟烷或麻醉性镇痛药补充需求无显著差异。我们得出结论,低剂量可乐定是老年患者管理中的一种有用辅助药物,且无副作用。

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