摘要
目的探讨右美托咪定对腹腔镜胆囊切除术患者气腹时心率变异性的影响。方法选择全麻下行腹腔镜胆囊切除手术患者45例,ASAI级,随机分为右美托咪定组(D组),瑞芬太尼组(R组),生理盐水组(C组),每组15例。麻醉诱导后,维持吸入1.0MAC七氟醚。在气腹前10分钟D组输注1μg/kg的右美托咪定;R组输注血浆靶控瑞芬太尼2ng/kg;C组输注生理盐水,并记录气腹前5分钟(T0)、人工气腹即时(T1)、人工气腹后5分钟(T2)的心率(HR)、平均动脉压(MAP)及计算心率变异性(HRV)。结果与T0比较,C组T1,T2的HR,MAP,低频(LF)和低频/高频(L/H)高于T0(P<0.05);R组和D组各时间点上的HR,MAP,LF和L/H与T0相比差异无统计学意义(P>0.05);组间比较:D组和R组在T1和T2的HR,MAP,LF和L/H低于C组(P<0.05)。D组和R组各时点间的差异没有统计学意义(P>0.05)。结论气腹前10分钟输注1μg/kg的右美托咪定能保持腹腔镜胆囊切除术患者气腹时的血流动力学平稳及交感迷走张力的均衡性。
Objective To investigate the effects of dexmedetomidine on heart rate variability induced by intraperitoneal carbon dioxide insufflation in laparoscopic cholecystectomy. Methods Forty- five ASA I patients undergoing elective laparoscopic cholecystectomy were randomly divided into three groups with 15 patients in each group： group D, group R and group C. Sevenflurance 1.0 MAC was kept after induction.Dexmedetomidine 1 μg/kg was infused 10 minutes before pneumoperitoneum in group D.Plasma target controlled remifentanil 2 ng/ml was given in group R.NorInal saline was infused in group C. The HR, MAP and HRV were recorded in five minutes before pneumoperitoneum （T0）, at the beginning of pneumoperitoneum （T1）, five minutes after pneumoperitoneum （T2）. Results HR, MAP, LF and L/H were significantly increased at Ti and T2 as compared with the baseline values at To in group （（P〈0.05）. In the every time point of the group R and group D compared with T0,the HR,MAP,LF and L/H were no statistical difference （P〉0.05）. HR,MAP,LF and L/H at T1 and T2 were lower in group D and group R than in group C（P〈0.05）. Compared with group R, group D was not significantly increased or decreased at three time points. Conclusion Dexmedetomidine 1 μg/kg infused 10minutes before pneumoperitoneum would maintain hemodynamic stability and sympathetic vagus tension balance during pneumoperitoneum in laparoscopic cholecystectomy.
出处
《岭南现代临床外科》
2011年第5期386-388,共3页
Lingnan Modern Clinics in Surgery
关键词
右美托咪定
胆囊切除术
气腹
心率变异性
Dexmedetomidine
Cholecystectomy
Pneumoperitoneum
Heart rate variability
