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右美托咪定在全身麻醉鼻内镜手术中的应用 预览 被引量:7

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摘要 目的 探讨右美托咪定在全身麻醉鼻内镜手术中行控制性低血压的安全性和有效性.方法 将60例择期全身麻醉下行鼻内镜手术患者按随机数字表法分为右美托咪定组和硝酸甘油组,每组30例.2组患者入室后建立静脉通道,输注平衡液.麻醉诱导后进行气管插管机械通气,维持PETCO2 4.67~6.00 kPa.术中吸入1.2 MAC七氟醚和泵注七氟醚0.1 μg· kg^-1· min^-1,瑞芬太尼维持麻醉.右美托咪定组在麻醉诱导前5 min泵注复合量右美托咪定1μg·kg^-1,15 min泵注完,继续以0.5 μg· kg^-1·h^-1泵注维持.硝酸甘油组麻醉诱导后给予硝酸甘油2~5 μg· kg^-1· min^-1行控制性降血压.2组均维持MAP为8.00~8.33 kPa.观察记录2组患者诱导前5 min(T0)、手术开始后30 min(T1)及拔管即刻(T2)的心率(HR)、MAP、降压达标时间、手术时间、降压持续时间、拔管时间、出血量及尿量的变化.结果 2组患者年龄、性别、体质量、手术时间及控制降血压持续时间等方面比较差异均无统计学意义(均P>0.05).2组患者T0的MAP、HR比较差异无统计学意义(均P>0.05).硝酸甘油组T1、T2的HR及T2的MAP明显高于右美托咪定组(均P<0.05).右美托眯定组降血压达标时间及拔管时间长于硝酸甘油组、出血量少于硝酸甘油组、尿量多于硝酸甘油组(均P<0.05).所有患者均无术中知晓、呼吸抑制等麻醉并发症发生.结论 在全身麻醉鼻内镜手术中应用右美托咪定行控制性低血压不良反应小,安全可行.
作者 柳欢 李鹏
出处 《实用临床医学(江西)》 CAS 2013年第12期35-36,38共3页 Practical Clinical Medicine
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