右旋美托咪啶用于食道癌手术麻醉的临床研究

目的：观察右旋美托咪啶用于食道癌手术麻醉的临床研究。方法：100例美国麻醉医师协会（ASA）Ⅰ-Ⅱ级择期行食道癌手术患者,随机分为生理盐水组（A组）和右旋美托咪啶组（B组）（n=50）,麻醉诱导前10min分别静脉注射右旋美托咪啶1μg／kg、生理盐水10ml后,两组麻醉诱导和维持相同。随后持续注射右旋美托咪啶0．4μg／kg·h直至手术结束前30min,观察与记录麻醉诱导前（T0）、插管即刻（T1）、拔管后1min（T2）、5min（T3）、10min（T4）平均动脉压（MAP）、心率（HR）、血氧饱和度（SaO2）、中心静脉压（CVP）、丙泊酚用量、芬太尼用量及不良反应。结果：T0、T1、T2,T3、T4A组与B组比较,MAP明显下降、HR明显减慢（P〈0．05）,丙泊酚和芬太尼用药量B组显著少于A组（P〈0．05）。B组术后咽喉疼痛、呛咳躁动发生率也明显低于A组（P〈0．05）。结论：右旋美托咪啶可减轻食道癌手术气管插管与拔管的心血管反应、减少麻醉药用量,减少胸科手术后咽喉疼痛、呛咳躁动的发生率。

Clinical observation of injection of dexmedetomidine in anaesthesia for esophageal cancer operation

Objective： To investigate the effects of administration of dexmedetomidine in anaesthesia for esophageal cancer operation. Methods： 100 patients（ASAⅠ-Ⅱ ） who were undergoing to esophageal cancer operation were randomly divided into control group（group A） and dexmedetomidine group （group B ） （ n = 50 ）. The scheme of induction and maintenance of aesthesia of the two groups were identical. Patients in group B administered dexmedetomidine at a dose of 1 μg/kg over 10 min and patients in group A were given a placebo infusion of normal saline. Patients in group B administered dexmedetomidine at a dose of 0.4 μg/（kg h） was injected and stoped at 30 min by the end of operation. Mean artery pressure （MAP） and heart rate （HR） were detected before induction（T0）, induction（T1 ）, 1 min after extubation（T2）, 5 min after extubation （T3） and 10min after extubation（T4） Propofol comsumption, fentanlyl comsumption, and side effects were recorded as well. Results： The results showed that MAP and HR （T0, T1, T2, T3, T4） in group B were significantly different from those in group A which fluctuated more markedly （ P 〈 0.05）. Pmpefol comsumption in group A was much more than that in group B （ P 〈 0.05）. Incidence of pharynx and larynx ache and restlessness were higher in group A than those in group B （ P 〈0.05）. Conclusion： Dexmedetomidine could effectively reduce the cardiovascular response to incubation and extubation in esophageal cancer operation patients. Propofol comsumption, fentardyl comsumption and side effects were reduceed as well.