摘要
目的探讨右美托咪啶（Dex）复合尼卡地平（Nic）用于耳科手术患者控制性降压的效果及其对术中应激反应的影响。方法选择60例ASAI-Ⅱ级行鼓室成形术的患者,随机分为2组（n=30）：尼卡地平组（N组）,Dex＋Nic组（DN组）。DN组麻醉诱导前15 min内静脉泵注Dex负荷剂量1μg/kg,继之以0.5μg/（kg·h）的速率输注至手术结束前30 min,术中维持Bl S值40~49。N组手术开始时以2~3μg/（kg·min）的速率输注Nic,使MAP降至并维持在60~65 mm Hg,缝合伤口时停药。记录术中药物用量、出血量、输液量及手术时间、清醒时间、拔管时间。检测麻醉诱导前（T0）,切皮前（T1）,手术1 h（T2）,术毕（T3）血浆皮质醇（Cor）及IL-6浓度。结果与N组比较,DN组术中麻醉药和Nic用量降低,清醒时间及拔管时间缩短（P〈0.05）,与T0时比较,N组T2、T3时血浆Cor、血清IL-6浓度明显升高（P〈0.05）。与N组比较,T2、T3时DN组血浆Cor、血清IL-6浓度均明显降低（P〈0.05）。结论右美托咪啶复合尼卡地平用于耳科手术患者,不仅能优化控制性降压的效果,而且能有效的抑制术中应激反应。
Objective To observe the effects of dexmedetomidine combined with nicardipine on controlled hypotension and stress reaction in patients undergoing otological surgery.Methods Sixty ASA I or 1I patients,scheduled for Tympanoplasty surgery,were randomly allocated into 2 groups（n=30 each）：nicardipine group（group N）and dexmedetomidine＋nicardipine group（group DN）.A loading dose of dexmedetomidine 1ug/kg was injected intravenously 15 mins before induction of anesthesia,followed by infusion at 0.5 ug/kg/h until 30 mins before the end of operation in group DN.BIS value was maintained at 40-49 during operation.Group N was performed with iv infusion of nicardipine at a rate of 2-3ug/kg/min,MAP was reduced to 60-65 mm Hg,then the infusion rate was adjusted to maintain MAP at this level,and nicardipine infusion was stopped while closing the skin.The amount of anesthetics and nicardipine consumed,blood loss,volume of fluid infused during operation and the operation time,emergence time and extubation time were recorded.The levels of serum IL-6,plasma cortisol were detected before the induction of anesthesia（T0）,before incision（T1）,l h after the beginning of the operation（T2）,at the end of the operation（T3）.Results Compared with group N,the amount of anesthetics and nicardipine consumed was significantly decreased,the emergence time and extubation time were significantly shortened（P〈0.05）,and no significant change in the volume of fluid infused and blood loss was found in group DN（P〉0.05）.Compared with T0,at T2,T3,serum IL-6 and plasma cortisol increased in group N（P〈0.05）.Compared with group N,at T2,T3,serum IL-6 and plasma cortisol decreased in group DN（P〈0.05）.Conclusion Dexmedetomidine combined with nicardipine not only can improve the efficacy of nicardipine for controlled hypotension,but also can reduce stress reaction when used in patients undergoing otological surgery.
出处
《分子影像学杂志》
2016年第1期27-29,共3页
Journal of Molecular Imaging
关键词
右美托咪啶
尼卡地平
控制性降压
应激反应
dexmedetomidine
nicardipine
controlled Hypotension
stress reaction
