不同剂量右美托咪啶用于非体外冠状动脉搭桥术麻醉诱导的观察

目的:观察不同剂量右美托咪啶用于不停跳冠状动脉搭桥术(CABG)麻醉诱导时镇静深度及血流动力学的变化。方法:60例美国麻醉医师学会(ASA)Ⅱ级拟行非体外CABG的患者随机分为3组,麻醉诱导前分别静脉滴注0.5μg/kg(D5组,n=20)、0.7μg/kg(D7组,n=20)及1μg/kg(D1组,n=20),记录入室及给药后Ramsay评分,以及入室后(T0)、右美托咪啶后(T1)、插管前(T2)、插管后即刻(T3)、插管后10min(T4)各时点BIS、HR及SBP。结果:3组患者给药后Ramsay评分与入室后相比均明显升高(P<0.05)。3组患者BIS、HR及SBP在给药后均呈下降趋势,D5组插管后即刻HR及SBP均明显高于插管前(P<0.05),且在插管后10min,BIS明显回升,而D7和D1组在插管前后及插管后10min BIS、HR及SBP均无明显变化。组间比较D1组BIS、HR及SBP下降最为明显,与D5和D7组相比均P<0.05。结论:诱导前静滴0.7μg/kg右美托咪啶可能更适合于非体外CABG的麻醉诱导。

Observation the effects of different dose dexmedetomidine to the anesthesia induction of off-pump coronary artery bypass grafting

Objective: To observe the sedative effects and hemodynamic changes after the use of different dose dexmedetomidine during the anesthesia induction of off-pump coronary artery bypass graft(CABG).Methods: Sixty ASAⅡ patients undergoing off-pump CABG were randomly divided into three groups,each group was given either 0.5 μg/kg(group D5,n=20),or 0.7μg/kg(group D7,n=20),or 1 μg/kg(group D1,n=20) dexmedetomidine by way of intravenous infusion before anesthesia induction.The Ramsay's value were recorded when the patients entered the room(base value) and after dexmedetomidine infusion.The BIS's value,HR and SBP were recorded at the time points of room enter(base value,T0),end of dexmedetomidine infusion(T1),before endotracheal intubation(T2),just after endotracheal intubation(T3),and 10min after intubation.Results: The Ramsay's value after dexmedetomidine infusion was significantly higher than base value in each group(P<0.05).Either of the BIS,HR and SBP had a decreasing tendency in each group from the T1 time point.In group D5,the HR and SBP were significantly higher at T3 time point than T2(P<0.05),and the BIS showed an obvious recovery at T4 point.The BIS,HR and SBP in Both of group D7 and D1 had no changes at the T2,T3 and T4 points.In group comparison,the reduction of BIS,HR and SBP had the most degrees compared to the other two groups.And the P value was less than 0.05 to each group D5 or D7.Conclusion: Giving 0.7 μg/kg dexmedetomidine before anesthesia induction by way of intravenous infusion may be more favorable to patients undergoing off-pump CABG.