摘要
目的 研究右美托咪定对腹腔镜行胆囊切除术患者心率变异性（HRV）的影响.方法 采用前瞻性、随机、双盲、安慰剂平行对照的研究方法,60例行腹腔镜胆囊切除术的患者,ASAⅠ或Ⅱ级,根据随机数字表随机均分为三组：0.4 μg/kg右美托咪定（Dex1组）、0.5μg/kg右美托咪定（Dex2组）和等容量生理盐水（NS组）在诱导开始时泵注（输注时间10 min）.所有患者均采用相同的麻醉诱导及维持方案.分别于麻醉诱导前即刻（T0）、气腹后1 min（T1）、5 min（T2）、10 min（T3）、20 min（T4）、放气腹后5 min（T5）时记录SBP、HR、低频功率（LF）、高频功率（HF）、LF/HF、总频（TF）.结果 与T0时比较,T4时Dex1组,T2、T4时Dex2组LF明显升高,T5时Dex1组LF明显降低（P＜0.05）;T3、T4时Dex1组,T2～T4时Dex2组HF、TF明显升高（P＜0.05）;T1时NS组LF/HF明显升高,T3、T4时Dex1组,T3时Dex2组的LF/HF明显降低（P＜0.05）.结论 麻醉诱导时单次应用右美托咪定不仅可以有效抑制腹腔镜手术引起的应激反应,维持围术期血流动力学平稳,而且可以改善交感/迷走神经的平衡状态.
Objective To evaluate effects of dexmedetomidine on heart rate variability （HRV） in patients with laparoscopic cholecystectomy.Methods A prospective,randomized,double-blind and placebo controlled clinical protocol was used in this study.sixty patients （ASA Ⅰ or Ⅱ） undergoing laparoscopic cholecystectomy were randomly allocated to three groups with 20 patients in each.When the induction of anesthesia started,dexmedetomidine 0.4 μg/kg （group Dex1）,0.5 μg/kg （group Dex2） or the same volume of normal saline （group NS） was infused intravenously within 10 min at induction.All patients received the same method of induction and the maintenance of anesthesia.SBP,HR,low frequency power （LF）,high frequency power （HF）,LF/HF ratio and total frequency power （TF） were recorded before induction of anesthesia （T0）,1 min after pneumoperitoneum （T1）,5 min after pneumoperitoneum （T2）,10 min after pneumoperitoneum （T3）,20 min after pneumoperitoneum （T4） and lifting of pneumoperitoneum after 5 rmin （T5）.Results Compared with baseline,the LF increased at T4 in group Dex1,and increased at T2 and T4 in group Dex2.The LF was lower at T5 in group Dex1 （P＜0.05）.The HF and TF increased at T3 and T4 in group Dex1,and increased at T2-T4 in group Dex2 （P＜0.05）.The LF/HF was higher at T1 in group NS.The LF/HF was lower at T3,T4 in group Dex1 and decreased at T3 in group Dex2 （P＜0.05）.Conclusion Infusion of dexmedetomidine during anesthesia induction can not only inhibit stress reaction of laparoscopic cholecystectomy,stabilize the hemodynamics,but also improve the equilibrium state of sympathetic and vagal activity.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2014年第3期225-227,共3页
Journal of Clinical Anesthesiology
关键词
右美托咪定
心率变异性
气腹
Dexmedetomidine
Heart rate variability
Pneumoperitoneum
