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右美托咪定对老年高血压患者围麻醉期血压、心率及血氧饱和度水平的影响

Effect of dexmedetomidine for blood pressure,heart rate and SpO2 levels during anesthesia inquiry in elderly hypertensive patients

摘要目的:探讨右美托咪定(DEX)对老年高血压(HBP)患者围麻醉期血压、心率(Heart Rate,HR)及血氧饱和度(SpO2)水平的影响。方法选择接受手术的老年 HT 患者96例,按照随机数字表法分成观察组48例和对照组48例,观察组患者在手术期间持续泵入4μg/mL 的 DEX,而对照组同样方法泵入0.9%氯化钠注射液。在入室后(T0)、输注 DEX 后(T1)、气管插管前(T2)、气管插管后2 min(T3)和气管插管后10 min(T4)分别统计两组患者的心率(HR)、收缩压(SBP)、舒张压(DBP)、脉搏氧饱和度(SpO2),手术结束后统计两组患者自主呼吸恢复时间、呼之睁眼时间和拔管时间,并统计两组患者心血管不良反应。结果两组 T0和 T4时的 HR、SBP、DBP、SpO2比较,差异均无统计学意义(均 P >0.05);T1、T2、T3时,观察组 HR、SBP和 DBP 明显低于对照组(均 P <0.05);两组 T0的 SpO2无明显变化;观察组自主呼吸恢复时间、呼之睁眼时间和拔管时间观察组均显著短于对照组(t =8.874、9.073、8.573,均 P <0.05);观察组不良反应率为4.2%,对照组为6.3%,两组差异无统计学意义(χ2=0.102,均 P <0.05)。结论老年 HBP 患者术中泵入 DEX 可以起到明显的镇静作用,且不产生呼吸抑制,可以帮助老年 HBP 患者平稳度过围手术期。

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abstractsObjective To explore the effect of dexmedetomidine(DEX)for blood pressure,heart rate(HR) and SpO2 levels during anesthesia inquiry in elderly hypertensive(HBP)patients.Methods 96 cases with HBP accepted surgery were selected,and were randomly divided into the observation group and the control group,each group in 48 cases,The patients in the observation group continuous pumped into the 4μg/mL of DEX during surgery, while the control group continuous pumped into 0.9% sodium chloride solution during surgery.Heart rate(HR),sys-tolic blood pressure(SBP),diastolic blood pressure(DBP),pulse oxygen saturation(SpO2 )of the two groups after room entrance(T0),after DEX infusion(T1),before intubation(T2),after 2min intubation(T3)and 10 min(T4)after intubation were recorded and compared,extubated time,spontaneous breathing recovery time,call time to eye opening and hospitalization time and the incidence of adverse reactions in two groups were recorded.Results The difference of HR SBP,DBP and SpO2 at T0 and T4 between the two groups was not statistically significant(all P >0.05);HR, SBP and DBP were significantly lower in the observation group than those in the control group at T1,T2,T3(all P <0.05).There were no significant changes of SpO2 in the patientˊs after the room entrance;extubated time,spontaneous breathing recovery time,call time to eye opening and hospitalization time in the observation group were significantly lower than those in the control group(t =8.874,9.073,8.573,all P <0.05).The adverse reactions rate in the observation group was 4.2%,which in the control group was 6.3%,the difference was not statistically significant(P >0.05). Conclusion Continuous pumped DEX has a significant sedative effect in elderly HBP patients during surgery,and does not produce respiratory depression,can help elderly patients with HBP smoothly pass the perioperative period.

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作者 蒋龑 [1] 程远 [2] 学术成果认领
作者单位 建德市中西医结合医院麻醉科, 浙江省建德,311612 [1] 杭州市第一人民医院 [2]
栏目名称
DOI 10.3760/cma.j.issn.1008-6706.2015.19.022
发布时间 2015-10-20(万方平台首次上网日期,不代表论文的发表时间)
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中国基层医药

中国基层医药

2015年19期

2950-2953页

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