[1]李航,刘强,陈建平,等.右美托咪定在老年椎管内麻醉中对麻黄碱升压作用的影响[J].中华老年骨科与康复电子杂志,2016,(04):234-238.[doi:10.3877/cma.j.issn.2096-0263.2016.04.008]
　Li Hang,Liu Qiang,et al.Effects of dexmedetomidine on pressor response to ephedrine in elderly patients undergoing intravertebral anesthesia[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):234-238.[doi:10.3877/cma.j.issn.2096-0263.2016.04.008]
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右美托咪定在老年椎管内麻醉中对麻黄碱升压作用的影响()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2016年04期
页码:
234-238
栏目:
围术期管理
出版日期:
2016-11-05

文章信息/Info

Title:
Effects of dexmedetomidine on pressor response to ephedrine in elderly patients undergoing intravertebral anesthesia
作者:
李航 1; 3; 刘强 2; 陈建平 3; 高翔 3; 贺艳芳 3; 郭芳 3; 崔剑 3
030001 太原，山西医科大学，麻醉学系 1；山西医学科学院山西大医院，骨科 2，麻醉科 3
Author(s):
Li Hang1;  3;  Liu Qiang2;  Chen Jianping3;  Gao Xiang3;  He Yanfang3;  Guo Fang3;  Cui Jian3
1Department of anesthesiology, Shanxi Medical University, Taiyuan, 030001, China; 2Department of Orthopaedics, 3Department of anesthesiology, Shanxi Academy of Medical Sciences Shanxi DaYi Hospital, Taiyuan, 030032, China
关键词:
老年人;  骨科;  右美托咪定;  麻黄碱;  血压
Keywords:
Aged;  Orthopedics;  Dexmedetomidine;  Ephedrine;  Blood pressure
DOI:
10.3877/cma.j.issn.2096-0263.2016.04.008
文献标志码:
A
摘要:
目的 探讨在老年人工股骨头置换或全髋关节置换术患者椎管内麻醉中，右美托咪定对麻黄碱升压作用的影响。方法 前瞻性收集 2012 年 2 月至 2015 年 6 月山西医学科学院山西大医院收治的择期行人工股骨头置换或全髋关节置换术的老年患者 64 例，随机分为对照组（C组，n=34）和右美托咪定组（D 组，n=30）。记录并比较两组患者入室后（T0）、蛛网膜下腔注药前（T1）、给予麻黄碱后 2 min（T2）、静注右美托咪定 10 min（T3）、30 min（T4）、60 min（T5）的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、心率（HR）以及脉搏氧饱和度（SpO2）。结果 与 T0、T1时比较，D组 SBP、DBP和 MAP值在 T2时明显升高，T3时达到最高，持续至 T4，差异有统计学意义（P＜0.05），各时间点 HR值无明显变化，差异无统计学意义（P＞0.05）；C组 SBP、DBP和 MAP值在 T2时升高，持续至 T3，T4时开始下降，差异有统计学意义（P＜0.05），T2时 HR值明显高于其余各时点，差异有统计学意义（P＜0.05）。两组间比较，D组 T3、T4时 SBP、DBP及 MAP值均高于 C组，差异有统计学意义（P＜0.05）。结论 在老年人工股骨头置换或全髋关节置换椎管内麻醉中，小剂量右美托咪定可增加麻黄碱升压作用和作用时间，使术中血流动力学更加稳定。
Abstract:
Objective To observe the effects of dexmedetomidine on pressor response to ephedrine in elderly patients with hip arthroplasty during intravertebral anesthesia. Methods Sixty elderly patients treated with hip arthroplasty in Shanxi Academy of Medical Sciences Shanxi DaYi Hospital between February 2012 and June 2015 were recruited and randomly divided into two groups: the control group (group C, n=34) and dexmedetomidine group (group D, n=30). The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and SpO2 of all patients were recorded when patients entering operation room (T0), before intrathecal injection (T1), 2 min after ephedrine injection (T2), 10 min(T3), 30 min (T4) and 60 min (T5) after dexmedetomidine intravenous infusion. Results Compared to T0 and T1, SBP, DBP and MAP in group D were increased at T2 (P<0.05), reached the highest at T3 (P<0.05) and lasted till T4 (P<0.05). There was no significant changes of HR at each time point (P>0.05); SBP, DBP and MAP were higher at T2, reached the highest at T3 (P<0.05), began decreasing at T4 (P<0.05) and HR at T2 (P<0.05) were higher than that at other time points (P<0.05). SBP, DBP and MAP at T3 and T4 in group D were higher than that in group C (P<0.05). Conclusion Low dose dexmedetomidine canenhance the pressor response and action time of ephedrine in elderly patients underwent hip arthroplasty intravertebral anesthesia and maintain the intraoperative hemodynamics stable.

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备注/Memo

备注/Memo:
基金项目：山西省卫生计生委科研课题（2014008）
更新日期/Last Update: 2017-04-01