右美托咪定用于全麻诱导的优越效果:延长非缺氧呼吸暂停时间

Yunbin Xie, Jin Wu, Yan Xia, Yongfeng Zheng, Xiaotian Liu, L. Min, Dong-hua Shao
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摘要

目的评价右美托咪定用于全麻诱导时对非缺氧性呼吸暂停持续时间的影响。方法80例女性患者,年龄18-64岁,体重指数18.5-24.9 kg/m2,美国麻醉学学会身体状况Ⅰ或Ⅱ级,MallampatiⅠ级或Ⅱ级,采用随机数表法分为右美托咪定组(D组)和常规组(C组)。D组静注右美托咪定0.5μg/kg,C组静注生理盐水40ml,10 min。两组均通过密闭面罩吸入纯氧8L/min,3min后依次静注芬太尼3μg/kg、依托咪酯0.3mg/kg和罗库0.6mg/kg,期间不进行辅助通气。气管插管后SpO2降至92%时,立即连接麻醉机进行机械通气。采集动脉血样进行血气分析,在进入手术室时、吸入纯氧前、开始注射芬太尼时以及SpO2降至92%时记录PaO2。记录试验期间心血管不良事件的发展情况和非缺氧性呼吸暂停的持续时间。结果与C组相比,心血管不良事件发生率显著降低,非缺氧性呼吸暂停持续时间延长,进入手术室时、吸入纯氧前、开始注射芬太尼时PaO2无明显变化,结论右美托咪定用于全麻诱导可延长非缺氧性呼吸暂停的持续时间,提高全麻诱导气管插管的安全性。关键词:右美托咪定;全身麻醉;非缺氧性呼吸暂停的持续时间
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Superior effect of dexmedetomidine used for induction of general anesthesia: prolonging duration of non-hypoxic apnoea
Objective To evaluate the effect of dexmedetomidine on the duration of non-hypoxic apnoea when used for induction of general anesthesia. Methods Eighty female patients, aged 18-64 yr, with body mass index of 18.5-24.9 kg/m2, of American Society of Anesthesiology physical status Ⅰ or Ⅱ, with Mallampati grade Ⅰ or Ⅱ, scheduled for elective surgery with general anesthesia requiring tracheal intubation, were divided into 2 groups (n=40 each) by a random number table method: dexmedetomidine group (group D) and conventional group (group C). Dexmedetomidine 0.5 μg/kg was intravenously infused over 10 min in group D, and the normal saline 40 ml was intravenously infused in group C. In two groups, pure oxygen 8 L/min was inhaled via the closed mask, 3 min later fentanyl 3 μg/kg, etomidate 0.3 mg/kg and rocuronium 0.6 mg/kg were intravenously injected in turn, assisted ventilation was not performed in this period.The anesthesia machine was immediately connected to perform mechanical ventilation when SpO2 was reduced to 92% after tracheal intubation.Arterial blood samples were collected for blood gas analysis, and PaO2 was recorded at the time of entering the operation room, immediately before inhaling pure oxygen, at the beginning of injecting fentanyl, and when SpO2 was decreased to 92%.The development of adverse cardiovascular events during the trial, and duration of non-hypoxic apnoea were recorded. Results Compared with group C, the incidence of adverse cardiovascular events was significantly decreased, and the duration of non-hypoxic apnoea was prolonged, and no significant change was found in PaO2 at the time of entering the operation room, immediately before inhaling pure oxygen, at the beginning of injecting fentanyl, and when SpO2 was decreased to 92% in group D (P<0.05). Conclusion Dexmedetomidine can prolong the duration of non-hypoxic apnoea and raise the safety of endotracheal intubation during general anesthesia induction when used for induction of general anesthesia. Key words: Dexmedetomidine; Anesthesia, general; Duration of non-hypoxic apnoea
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中华麻醉学杂志
中华麻醉学杂志 Medicine-Anesthesiology and Pain Medicine
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