Narcotrend监测下右美托咪定对冠心病患者麻醉诱导期血流动力学的影响

观察Narcotrend监测下右美托咪定联合丙泊酚靶控输注用于冠心病患者非心脏手术麻醉诱导时对血流动力学的影响.合并冠心痛行非心脏手术患者40例,随机分为两组：Dex组（n=20,患者在诱导前静脉泵注右美托咪定0.5μg/kg,15min内输注完毕）,对照组（n=20,等量生理盐水,方法同Dex组）.记录给药前后及诱导期间患者的血流动力学变化.对照组在气管插管即刻以及气管插管3min后血流动力学指标值均高于插管前,气管插管5min后平均动脉压（MAP）低于插管前（P＜0.05）,Dex组无明显差异.麻醉诱导前15min静脉注射0.5μg/kg右美托咪定可以使冠心病患者丙泊酚靶控输注诱导期间血流动力学更加平稳.

Influence of Dexmedetomidine with Target-controlled Infusion of Propofol Guided by Narcotrend on Hemodynamics during Anesthetic Induction in Patients with Coronary Heart Disease Undergoing Non-cardiac Surgery

To evaluate the influence of dexmedetomidine combined with target controlled infusion of propofol on hemodynamics during anesthetic induction in patients with coronary heart disease undergoing non-cardiac surgery. Forty patients with coronary heart disease scheduled for elective major non-cardiac surgery were randomly divided into 9, groups Dex group （n=20）and control group （n=20）. In Dex group, 0. 5btg/kg of dexmedetomidine was administered in intravenous for over 15 minutes, while in control group, same volume of normal saline was given. After infusion,anesthesia was induced with target-controlled infusion of propofol. The SBP, DBP, MAP, HR were recorded at the time before dexmedetomidine infusion, 15 min after dexmedetomidine infused and during anesthesia induction. Compared with before intubation, SBP, DBP, MAP, HR were higher in control group at endotrachal intubation and 3rain after endotracheal intubation, and MAP was lower at 5rain after endotracheal intubation compared with before endotrachal intubation （P〈0.05）. Those in Dex group did not change obviously. Dexmedetomidine with a 0. 5μg/kg loading dose before target-controlled pump infusion of propofol could keep hemodynamies stabilization in patients with coronary heart disease undergoing non-cardiac surgery.