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    find Author "史金麟" 2 results
    • 右美托咪定對老年高血壓患者全身麻醉拔管期血流動力學的影響

      目的觀察右美托咪定對老年高血壓患者全身麻醉(全麻)拔管期血流動力學的影響。 方法選擇2011年5月-2012年4月期間擇期行腹部手術的老年高血壓患者60例,年齡>65歲,美國麻醉醫師協會分級Ⅰ~Ⅱ級,高血壓Ⅱ~Ⅲ級。隨機分為右美托咪定組(A組)和對照組(B組),均采用靜吸復合麻醉,手術結束前40 min分別靜脈微量泵入右美托咪定0.3 μg/kg和生理鹽水20 mL,輸注時間20 min。記錄各時點平均動脈壓(MAP)和心率(HR)。 結果A組拔管期各時點平均MAP、HR明顯低于B組(P<0.05)。 結論右美托咪定能有效降低老年高血壓患者全麻拔管期血流動力學波動,預防心腦血管意外的發生。

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    • Application of Dexmedetomidine Combined with Etomidate for Elderly Patient Undergoing thyroidectomy

      ObjectiveTo observe the effect of dexmedetomidine combined with etomidate on the clinical safety and the tracheal extubation response after general anesthesⅠa in elderly patient undergoing thyroidectomy. MethodsFifty patients (aged between 65 and 75 years, ASAⅠor Ⅱ) scheduled for thyroid surgery between July 2012 and January 2013 were randomly divided into two groups:dexmedetomidine group (group D) and control group (group C) with 25 patients in each group. Group D received dexmedetomidine of 0.5 μg/(kg·h) through intravenous infusion after anesthesia induction, and the intravenous infusion was stopped five minutes before the end of surgery. Normal saline was infused at the same volume in group C at the same time. Patients were induced with etomidate at 0.2 mg/kg for anesthesia, and etomidate and remifentanil were used for the anesthesia maintenance during the operation. Heart rate (HR), systolic blood pressure SBP), diastolic blood pressure (DBP) and bispectral index (BIS) were recorded 5 (T1), 15 (T2) and 30 (T3) minutes after the beginning of the operation, and 15 (T4) and 5 (T5) minutes before the end of the operation. Moreover, the time of eye opening, time of extubation, the number of patients with restlessness and etomidate requirement were recorded. ResultsCompared with group C, HR and MAP at the time points of T2 and T5 in group D did not obviously change, but the number of restlessness patients in group D was significantly less than in group C (P<0.05). There was no statistically significant difference in time of eye opening and time of extubation between the two groups (P>0.05). Etomidate requirement in group D was[(8.6±2.1) μg/(kg·min)], which was significantly lower than that in group C[(14.4±3.4) μg/(kg·min)] (P<0.05). ConclusionDexmedetomidine combined with etomidate is efficient and safe for elderly patients undergoing thyroidectomy, and this method can effectively reduce cardiovascular responses to tracheal extubation, decrease the incidence of postoperative restlessness, and reduce the requirement of etomidate during the operation.

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