BMC Anesthesiol:一定负荷剂量的右美托咪定复合异丙酚或七氟醚时对麻醉维持期间血流动力学变化的比较:一项前瞻性随机双盲对照临床试验

2018-02-04 李华宇 “罂粟花”微信号

右美托咪定对血流动力学的影响可能存在很大的个体差异。因此,必须仔细调整剂量以达到预期的临床效果。在麻醉维持期间,一定负荷剂量的右美托咪定是否会产生血流动力学的副作用是未知的。本研究的目的是比较一定负荷剂量的右美托咪定复合异丙酚或七氟醚时对麻醉维持期间血流动力学变化的影响。

背景与目的:右美托咪定对血流动力学的影响可能存在很大的个体差异。因此,必须仔细调整剂量以达到预期的临床效果。在麻醉维持期间,一定负荷剂量的右美托咪定是否会产生血流动力学的副作用是未知的。本研究的目的是比较一定负荷剂量的右美托咪定复合异丙酚或七氟醚时对麻醉维持期间血流动力学变化的影响。

方  法:84例行平衡全麻手术的患者被随机分为4组(n=21例):异丙酚+右美托咪定组,七氟醚+右美托咪定组,异丙酚+生理盐水组,七氟醚+生理盐水组。记录该研究药物(右美托咪定或生理盐水)输注之前,之后5分钟和结束时的血流动力学指标。评估研究药物输注结束时血压升高(大于基线或研究药物输注前的20%)的发生率。

结  果:异丙酚复合右美托咪定组在静脉注射右美托咪定后较前相比平均动脉压显着升高(P <0.01)。异丙酚复合右美托咪定组80%的患者平均动脉压升高,而七氟醚复合右美托咪定组仅有5%(P <0.05)。异丙酚复合右美托咪定组以及七氟醚复合右美托咪定组的心率在右美托咪定输注后均显着降低(P <0.01)。

结  论:术中给予一定负荷剂量的右美托咪定复合异丙酚时使麻醉维持期间的血压显着升高。反之,它与七氟醚联合使用则不会使血压升高。同时由于已知的右美托咪定的副作用,右美托咪定复合异丙酚或七氟醚时使心率降低在意料之中。因此,在整个静脉麻醉维持期间,特别是使用异丙酚时,应谨慎使用右美托咪定。

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  4. 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likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89162, encryptionId=3704891621c, topicName=血流动力学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99cf2500102, createdName=zjshifan_98647306, createdTime=Tue Feb 06 10:06:00 CST 2018, time=2018-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412680, encodeId=57da1412680f0, content=<a href='/topic/show?id=1c2f195092d' target=_blank style='color:#2F92EE;'>#七氟醚#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19509, encryptionId=1c2f195092d, topicName=七氟醚)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0a102881238, createdName=linagood, createdTime=Tue Feb 06 10:06:00 CST 2018, time=2018-02-06, status=1, ipAttribution=)]
    2019-01-17 amyloid
  5. 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  6. 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  7. 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likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89162, encryptionId=3704891621c, topicName=血流动力学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99cf2500102, createdName=zjshifan_98647306, createdTime=Tue Feb 06 10:06:00 CST 2018, time=2018-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412680, encodeId=57da1412680f0, content=<a href='/topic/show?id=1c2f195092d' target=_blank style='color:#2F92EE;'>#七氟醚#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19509, encryptionId=1c2f195092d, topicName=七氟醚)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0a102881238, createdName=linagood, createdTime=Tue Feb 06 10:06:00 CST 2018, time=2018-02-06, status=1, ipAttribution=)]
    2018-04-09 1522236e72m

    学习了.

    0

  8. 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    2018-02-07 Anne0711

    学习一下

    0

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