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不同剂量右旋美托咪定用于女性患者全麻诱导期的临床观察
Clinical Observation of the Effective Dose of Dexmedetomidine for Induction of General Anesthesia in Female Patients
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DOI:
作者:
沈富毅,徐振东,薛庆生,刘志强,于布为
SHEN Fu-yi, XU Zhen-dong, XUE Qing-sheng, LIU Zhi-qiang, YU Bu-wei
作者单位:
同济大学附属第一妇婴保健院,同济大学附属第一妇婴保健院,上海交通大学医学院附属瑞金医院,同济大学附属第一妇婴保健院,上海交通大学医学院附属瑞金医院
Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine Department of Anesthesiology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine Department of Anesthesiology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine
关键词:
右旋美托咪定,全麻诱导,镇静,血液动力学,不良反应
dexmedetomidine,induction of general anesthesia,sedation,hemodynamics,side effect
摘要:
目的:探讨右旋美托咪定(Dexmedetomidine,Dex)用于全麻诱导期的合理剂量。方法:选择80例ASAⅠ-Ⅱ级择期手术女性患者,随机分为4组,每组20例。I组于全麻诱导前静脉注射Dex 0.6ug/kg;II组静脉注射Dex 0.8ug/kg;III组静脉注射Dex 1.0ug/kg;IV组为空白对照组,静脉注射生理盐水10ml。注射Dex 10min后对患者行改良OAA/S镇静评分,然后行异丙酚TCI诱导,效应室靶浓度(Ce)达到3.0ug/ml行气管插管。记录各时间点的BIS、收缩压、心率。术后随访患者有无头痛、口干及术中知晓。结果:给药后10min,I, II, III组均可产生明显的镇静作用。在抑制气管插管时血液动力学波动方面, III组>II组>I组。但III组的低血压和心动过缓发生率显著高于其余三组。结论:气管插管前单次静脉泵注右旋美托咪定0.8ug/kg,可获得较满意的镇静效果,并有效减弱气管插管时的血液动力学波动,且该剂量不良反应的发生率较小。
Purpose:We decided to search for the effective dose of dexmedetomidine as an adjuvant for induction of general anesthesia. Methods: Eighty American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ female patients undergoing elective surgery were randomized enrolled into 4 groups. Group I received dexmedetomidine 0.6ug/kg; group II 0.8ug/kg; group III 1.0ug/kg; and group IV received saline 10ml as control. Patients were given a dexmedetomidine or placebo infusion for at least 10 min before anesthesia induction. General anesthesia was induced with propofol, fentanyl and vecuronium. Results: Ten minutes after the dexmedetomidine used, the obvious sedative effect in group I, II, and III was observed. There was the minimum inhibition of circulation in group I and the maximum in group III. In group II and group III, the stress response was reduced during the intubation, but not in group I. The incidence of hypotension and bradycardia was highest in group III. Conclusion: Based on this study, the appropriate dose of dexmedetomidine as an adjuvant for induction of general anesthesia is 0.8ug/kg because of its satisfactory sedation, reduction of the stress response to the tracheal intubation and its low incidence of the side effects.
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