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目的探讨右美托咪定诱导对经鼻蝶垂体瘤手术围术期的影响。方法选择2013年3月—2016年5月温州医科大学附属第五医院麻醉科经鼻蝶垂体瘤手术患者50例作为研究对象,根据随机数字法将其分为右美托咪定组和对照组各25例,右美托咪定组在诱导前15 min经静脉泵入右美托咪定,对照组在诱导前15 min经静脉泵入等量生理盐水,观察2组患者各时间点收缩压、舒张压和心率变化以及2组患者瑞芬太尼和丙泊酚用量、手术时间和拔管时间。结果右美托咪定组插管后5 min、拔管后5 min和拔管后10 min收缩压均低于对照组相应时间点收缩压(P<0.05)。右美托咪定组插管后5 min、拔管后5 min和拔管后10 min舒张压均低于对照组相应时间点舒张压(P<0.05)。右美托咪定组插管前、插管后5 min和拔管后5 min心率均低于对照组相应时间点心率(P<0.05)。右美托咪定组和对照组瑞芬太尼和丙泊酚用量比较差异无统计学意义(P>0.05)。右美托咪定组手术时间和拔管时间和对照组比较差异无统计学意义(P>0.05)。结论右美托咪定诱导有利于经鼻蝶垂体瘤手术患者围手术期收缩压、舒张压和心率的稳定,并且不影响麻醉药用量、手术时间和拔管时间。
Objective To investigate the effects of dexmedetomidine on the perioperative period of pituitary tumors. METHODS: From March 2013 to May 2016, 50 patients with nasal pituitary tumors undergoing anesthesia in the Fifth Affiliated Hospital of Wenzhou Medical University were enrolled. According to the random number method, they were divided into two groups: the dexmedetomidine group and the control group 25 cases in each group. The dexmedetomidine group was intravenously injected with dexmedetomidine 15 minutes before induction, and the control group was injected with an equal volume of normal saline 15 minutes before induction. The systolic pressure , Changes of diastolic blood pressure and heart rate as well as remifentanil and propofol dosage, operation time and extubation time in two groups. Results The systolic blood pressure at 5 min after intubation, 5 min after extubation and 10 min after extubation were lower in dexmedetomidine group than those in control group (P <0.05). The diastolic blood pressure at 5 min after intubation, 5 min after extubation and 10 min after extubation were lower in the dexmedetomidine group than those in the control group at the corresponding time point (P <0.05). Dexmedetomidine group before intubation, 5 min after intubation and 5 min after extubation heart rate were lower than the control group at the corresponding time point heart rate (P lt; 0.05). There was no significant difference in the dosage of remifentanil and propofol between dexmedetomidine group and control group (P> 0.05). There was no significant difference in the operation time and extubation time between the dexmedetomidine group and the control group (P> 0.05). Conclusion Dexmedetomidine is beneficial to the stability of systolic blood pressure, diastolic blood pressure and heart rate during perioperative period in patients with transnasal pituitary tumor without affecting the anesthetic dosage, operation time and extubation time.