摘要
目的:探讨不同剂量右美托咪定对全身麻醉(全麻)手术患者围术期心肌细胞电生理的影响。方法:选取2020年5月至2021年12月期间于天津市蓟州区人民医院行择期全麻下经尿道钬激光软镜碎石手术治疗的120例患者,按随机数字表法分成3组,各40例。A组、B组、C组于10 min内分别静脉泵注负荷剂量右美托咪定1μg/kg、1μg/kg、0.5μg/kg,后分别以1μg·kg^(-1)·h^(-1)、0.5μg·kg^(-1)·h^(-1)、0.5μg·kg^(-1)·h^(-1)右美托咪定作为麻醉维持。对比三组不同时间点[静脉泵注负荷剂量的右美托咪定前即刻(T1)、完成负荷剂量泵注时(T2)、术毕即刻(T3)、术后1 h(T4)、术后24 h(T5)]心肌细胞电生理指标水平及心律失常发生率。结果:A组、B组T2时的PR间期较C组更长,C组T2、T3、T4时QTc间期较A组更短,C组T2时QTc间期较B组更短,差异有统计学意义(P<0.05);C组T4、T5时的Tp-e间期较A组更短,T5时Tp-e间期较B组更短,差异有统计学意义(P<0.05);C组围术期心律失常发生率低于A组、B组,差异有统计学意义(P<0.05)。结论:全麻手术患者术中静脉泵注负荷剂量0.5μg/kg与维持剂量0.5μg·kg^(-1)·h^(-1)的右美托咪定,能更好地维持围术期心肌细胞电生理稳定,减少心律失常发生,可于临床推广。
Objective:To investigate the effect of different doses of dexmedetomidine on the electrophysiology of cardiac myocytes in patients undergoing general anesthesia.Methods:120 patients who underwent elective general anesthesia surgery in Tianjing Jizhou District People's Hospital from May 2020 to December 2021 were randomly divided into 3 groups with 40 patients each.Group A,group B and group C were injected with a loading dose of dexmedetomidine 1 by intravenous pump within 10 minutes 1μg/kg、1μg/kg、0.5μg/kg,and then 1μg·kg^(-1)·h^(-1)、0.5μg·kg^(-1)·h^(-1)、0.5μg·kg^(-1)·h^(-1)dexmedetomidine was used as anesthesia maintenance.The levels of myocardial electrophysiological indexes and the incidence of cardiac arrhythmias were compared in the three groups at different time points[immediately before intravenous infusion of load dose of dexmedetomidine(T1),immediately after completion of load dose of dexmedetomidine(T2),immediately after operation(T3),1H(T4)after entering the post anesthesia recovery room(PACU),and 24 h(T5)].Results:The PR interval of group A and group B at T2 was longer than that of group C,the QTc interval of group C at T2,T3 and T4 was shorter than that of group A,and the QTc interval of group C at T2 was shorter than that of group B(P<0.05);the Tp-e interval at T4 and T5 in group C was shorter than that in group A,and the Tp-e interval at T5 was shorter than that in group B(P<0.05);the incidence of perioperative arrhythmia in group C was lower than that in group A and group B(P<0.05).Conclusion:The intravenous pump loading dose of 1μg/kg and maintenance dose 0.5μg·kg^(-1)·h^(-1)dexmedetomidine can better maintain the electrophysiological stability of cardiac myocytes during perioperative period and reduce the occurrence of arrhythmia,which can be popularized in clinical practice.
作者
刘洋
LIU Yang(Tianjing Jizhou District People's Hospital,Tianjin 301900,China)
出处
《药品评价》
CAS
2022年第17期1076-1079,共4页
Drug Evaluation
关键词
右美托咪定
碎石术
激光
围手术期
麻醉
全身
心肌细胞电生理
Dexmedetomidine
Lithotripsy,Laser
Perioperative period
Anesthesia,general
Electrophysiology of cardiomyocytes
