右美托咪定麻醉对高血压患者苏醒期躁动和血流动力学的影响(1)
[摘要]目的 探索右美托咪定麻醉对高血压患者苏醒期躁动和血流动力学的影响。方法 选择我院2014年7月～2016年7月收治的86例有高血压病史需要进行全麻手术患者的临床资料作为观察对象，根据随机数字表法将其分成试验组和对比组，每组各43例。在手术结束前60 min，给对比组患者静脉微泵注射20 ml生理盐水，给试验组患者静脉微泵注射0.5 μg/kg右美托咪定，比较两组患者全麻睡醒期躁动程度、疼痛程度及T0～T4各时段的血流动力学。结果 试验组患者的苏醒期躁动率(13.95%)明显低于对比组(48.84%)，差异有统计学意义(P<0.05)；试验组患者术后1 h VAS评分明显低于对比组，差异有统计学意义(P<0.05)；试验组患者拔管期各时点的平均动脉压(MAP)、心率(HR)明显低于对比组，差异有统计学意义(P<0.05)。结论 右美托咪定对高血压患者麻醉苏醒期的躁动程度的降低有较大的作用，使患者的血流动力学保持稳定，减少患者术后的疼痛程度，提高了患者的苏醒质量。
[关键词]高血压；右美托咪定；麻醉苏醒期躁动；血流动力学
[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721(2017)05(c)-0056-03
[Abstract]Objective To explore the effect of dexmedetomidine on agitation and hemodynamics in hypertensive patients during recovery period.Methods From July 2014 to July 2016，clinical data from 86 hypertensive patients undergone surgeries via general anesthesia were selected as observation objects.According to a random number table，they were evenly divided into experimental group and control group.Sixty minutes before the end of the operation，20 ml saline by intravenous micro-pump injection was used for patients in the control group.In the experimental group，0.5 μg/kg dextromethorphan via intravenous micro-pump injection was applied.Theagitation，pain degree，and hemodynamics at T0 to T4 during recovery period in the two groups were compared.Results In the experimental group，the agitation rate during recovery period was 13.95%，much lower than that in the control group accounting for 48.84% with a statistical difference (P<0.05).The score of VAS one-hour after surgery in the experimental group was greatly lower than that in the control group with a statistical difference (P<0.05).The mean arterial pressure (MAP) and heart rate (HR) at different time points in the experimental group were lower than those in the control group with statistical differences(P<0.05).Conclusion Deemethomidine has a great effect on the reduction of restlessness during anesthesia recovery in hypertensive patients.It maintains the stability of hemodynamics，alleviates postoperative pain degree，and improves the awakening quality.
[Key words]Hypertension；Dexmedetomidine；Anesthesia；Awakeningrecovery；Hemodynamics
高血壓的主要特征为以体循环动脉血压增高，它是一种临床综合征，常伴有心、脑、肾等器官的功能或器质性损害[1]。高血压患者在手术期间很容易发生并发症[2]。全身麻醉苏醒时血流动力学波动较大，麻醉管理的关键是维持患者循环功能稳定、保持心肌氧供需平衡、防止围术期心肌缺血并发症[3]。右美托咪定(DEX)是一种新型的α2肾上腺素能受体激动剂[4]。有研究显示，右美托咪定有良好的镇静、镇痛功效，可有效减少丙泊酚及阿片类药的用量，对患者麻醉后的复苏有极大的改善作用，减少躁动、寒战、术后恶心呕吐的发生[5]。本文通过对本院收治的86例有高血压病史需要进行全麻的手术患者进行研究，探讨右美托咪定麻醉对其苏醒期躁动和血流动力学的影响。
1资料与方法 (柳琦)
[关键词]高血压；右美托咪定；麻醉苏醒期躁动；血流动力学
[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721(2017)05(c)-0056-03
[Abstract]Objective To explore the effect of dexmedetomidine on agitation and hemodynamics in hypertensive patients during recovery period.Methods From July 2014 to July 2016，clinical data from 86 hypertensive patients undergone surgeries via general anesthesia were selected as observation objects.According to a random number table，they were evenly divided into experimental group and control group.Sixty minutes before the end of the operation，20 ml saline by intravenous micro-pump injection was used for patients in the control group.In the experimental group，0.5 μg/kg dextromethorphan via intravenous micro-pump injection was applied.Theagitation，pain degree，and hemodynamics at T0 to T4 during recovery period in the two groups were compared.Results In the experimental group，the agitation rate during recovery period was 13.95%，much lower than that in the control group accounting for 48.84% with a statistical difference (P<0.05).The score of VAS one-hour after surgery in the experimental group was greatly lower than that in the control group with a statistical difference (P<0.05).The mean arterial pressure (MAP) and heart rate (HR) at different time points in the experimental group were lower than those in the control group with statistical differences(P<0.05).Conclusion Deemethomidine has a great effect on the reduction of restlessness during anesthesia recovery in hypertensive patients.It maintains the stability of hemodynamics，alleviates postoperative pain degree，and improves the awakening quality.
[Key words]Hypertension；Dexmedetomidine；Anesthesia；Awakeningrecovery；Hemodynamics
高血壓的主要特征为以体循环动脉血压增高，它是一种临床综合征，常伴有心、脑、肾等器官的功能或器质性损害[1]。高血压患者在手术期间很容易发生并发症[2]。全身麻醉苏醒时血流动力学波动较大，麻醉管理的关键是维持患者循环功能稳定、保持心肌氧供需平衡、防止围术期心肌缺血并发症[3]。右美托咪定(DEX)是一种新型的α2肾上腺素能受体激动剂[4]。有研究显示，右美托咪定有良好的镇静、镇痛功效，可有效减少丙泊酚及阿片类药的用量，对患者麻醉后的复苏有极大的改善作用，减少躁动、寒战、术后恶心呕吐的发生[5]。本文通过对本院收治的86例有高血压病史需要进行全麻的手术患者进行研究，探讨右美托咪定麻醉对其苏醒期躁动和血流动力学的影响。
1资料与方法 (柳琦)