右美托咪定对喉镜及插管后肾上腺素能反应抑制作用的评价

D. Nava, J. Núñez, B. Hernandez, Andilay Pota Barito, A. Diab
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引用次数: 0

摘要

目的:右美托咪定是一种有效的α-2受体激动剂,具有交感神经溶解、镇静和镇痛作用。直接喉镜检查和气管插管与交感反射放电引起的血流动力学改变有关;引起高血压、心动过速和心律失常。已有几种药物用于控制这种血流动力学反应,但没有一种是无害的。材料与方法:选取60例患者,随机分为两组,DM1组给予右美托咪定0.5 μg/kg剂量,DM2组给予右美托咪定1 μg/kg稀释至100cc溶液,10 min内给药,验证两期血流动力学指标(HR、收缩压、舒张压、MAP)及镇静作用。结果:在第一阶段,与基线相比,DM1组在5分钟和10分钟的收缩压分别下降了9%和11% (p=0.8443和p=0.1650)。DBP和PAM也有类似的趋势。第二阶段收缩压、舒张压、MAP差异有统计学意义。结论:静脉负荷剂量为0.5 μg/kg的右美托咪定插管前后血流动力学稳定,无不良反应。
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Evaluation of the Effect of Dexmedetomidine on the Suppression of the Adrenergic Response to Laryngoscopy and Intubation
Objectives: Dexmedetomidine is a potent agonist of α-2 receptors with sympatholytic, sedative and analgesic properties. Direct laryngoscopy and endotracheal intubation are associated with hemodynamic changes due to reflex sympathetic discharge; causing hypertension, tachycardia and arrhythmias. Several drugs have been used to control this haemodynamic response however, none harmless. Materials and methods: Sample of 60 patients, divided into two groups, the DM1 group received a dexmedetomidine dose of 0.5 μg/kg, and the DM2 group received a dose of 1 μg/kg of the same drug diluted in 100 cc of solution, which it was administered in 10 min. The hemodynamic variables (HR, SBP, DBP and MAP) and sedation during two periods were verified. Results: In the first stage there was a decrease in the SBP in the DM1 group of 9 and 11% with respect to the baseline at 5 and 10 min (p=0.8443 and p=0.1650). Similar trends were found with the DBP and the PAM. In the second stage, SBP, DBP and MAP showed statistically significant differences. Conclusion: Dexmedetomidine at an intravenous loading dose of 0.5 μg/kg presents hemodynamic stability before and after intubation, with no evidence of adverse effects.
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