[1]谈世刚　鲁汉杰　宋晓阳.右美托咪定滴鼻对老年颅内动脉瘤栓塞全麻插管期脑血流动力学的影响[J].中国临床神经外科杂志,2019,(09):537-539.[doi:10.13798/j.issn.1009-153X.2019.09.008]
　TAN Shi-gang,LU Han-jie,SONG Xiao-yang.Effect of intranasal administration of dexmedetomidine on cerebral hemodynamics during general anesthesia in elderly patients with cerebral aneurysms undergoing intervenient therapy[J].,2019,(09):537-539.[doi:10.13798/j.issn.1009-153X.2019.09.008]
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右美托咪定滴鼻对老年颅内动脉瘤栓塞全麻插管期脑血流动力学的影响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年09期
页码:
537-539
栏目:
论著
出版日期:
2019-09-20

文章信息/Info

Title:
Effect of intranasal administration of dexmedetomidine on cerebral hemodynamics during general anesthesia in elderly patients with cerebral aneurysms undergoing intervenient therapy
文章编号:
1009-153X（2019）09-0537-03
作者:
谈世刚　鲁汉杰　宋晓阳
430070 武汉，中国人民解放军中部战区总医院麻醉科（谈世刚、鲁汉杰、宋晓阳）
Author(s):
TAN Shi-gang;  LU Han-jie;  SONG Xiao-yang
Department of Anesthesia, General Hospital, Central Theater, PLA, Wuhan 430070, China
关键词:
颅内动脉瘤; 介入治疗; 右美托咪定; 滴鼻; 老年; 插管期; 脑血流动力学
Keywords:
Cerebral aneurysms;  Intervenient therapy;  Dexmedetomidine;  Nasal drip;  Elderly patients;  Intubation period;  Cerebral hemodynamics
分类号:
R 743.9; R 614.2
DOI:
10.13798/j.issn.1009-153X.2019.09.008
文献标志码:
A
摘要:
目的 探讨右美托咪定滴鼻对老年颅内动脉瘤介入治疗全麻插管期脑血流动力学的影响。方法 选择2018年3~12月全麻下栓塞治疗的老年颅内动脉瘤60例，根据滴鼻方法分为对照组和观察组，每组30例。全麻诱导前30 min，观察组经鼻腔滴入右美托咪定0.5 μg/kg，对照组用等量生理盐水滴鼻；麻醉诱导后脑电双频谱指数值在40~60时进行气管插管。记录滴鼻30 min（T0）、气管插管即刻（T1）、插管后1 min（T2）、插管后3 min（T3）、插管后5 min（T4）平均动脉压（MAP）、心率（HR）、左侧大脑中动脉峰值血流速度（Vp-MCA）、左侧大脑中动脉平均血流速度（Vm-MCA）、搏动指数（PI）。结果 与T0比较，对照组T1~3 MAP、Vp-MCA、Vm-MCA均明显升高（P<0.05），HR均明显增快（P<0.05），PI均明显降低（P<0.05）；而观察组T1~4 MAP、Vp-MCA、Vm-MCA、HR、PI均无明显变化（P>0.05）。与对照组比较，观察组T1~3 MAP、Vp-MCA、Vm-MCA均明显降低（P<0.05）、HR均明显减慢（P<0.05）、PI均明显增加（P<0.05）。结论 全麻诱导前30 min右美托咪定0.5 μg/kg滴鼻能抑制老年颅内动脉瘤介入治疗插管期诱发的心血管反应和脑血流量增加。
Abstract:
Objective To investigate the effect of intranasal administration of dexmedetomidine on the cerebral hemodynamics during general anesthesia in the elderly patients with cerebral aneurysms undergoing intervenient therapy. Methods Of 60 patients with intracranial aneurysms undergoing intervenient therapy, 30 (observed group) received intranasal administration of 0.5 μg/kg dexmedetomidine and 30 (control group) intranasal administration of isovolumetric physiological saline 30 minutes before the induction of general anesthesia. The endotracheal intubation was performed when the bispectral index value was between 40 and 60 after the anesthesia induction. The mean arterial pressure (MAP), heart rate (HR), left middle cerebral artery peak blood flow velocity(Vp-MCA), left middle cerebral artery mean blood flow velocity (Vm-MCA) and pulsatility index (PI) were recorded 30 minutes after the intranasal administration of drug (T0), immediately after endotracheal intubation (T1), 1 minute after the intubation (T2), 3 minutes after the intubation (T3), and 5 minutes after the intubation (T4). Results The MAP, Vp-MCA, Vm-MCA and HR were significantly higher and PI was significantly lower at T1-3 than those at T0 in the control group (P<0.05). The MAP, Vp-MCA, Vm-MCA and HR were significantly lower, and PI was significantly higher in the observed group than those in the control group at T1~3 (P<0.05). Conclusion The intranasal administration of 0.5 μg/kg dexmedetomidine 30 minutes before the induction of general anesthesia can inhibit the cardiovascular responses and increase cerebral blood flow during the intubation in the elderly patients with cerebral aneurysms undergoing intervenient therapy.

参考文献/References:

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备注/Memo

备注/Memo:
通讯作者：宋晓阳，E-mail：songxiaoyang1234@163.com（2018-08-20收稿，2019-03-25修回）
更新日期/Last Update: 2019-09-20