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首页> 外文期刊>Egyptian Journal of Anaesthesia >Efficacy of different dexmedetomidine regimens in producing controlled hypotensive anesthesia during functional endoscopic sinus surgery
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Efficacy of different dexmedetomidine regimens in producing controlled hypotensive anesthesia during functional endoscopic sinus surgery

机译：不同右美托咪定方案在功能性内窥镜鼻窦手术中产生控制性降压麻醉的功效

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Background The study was designed to assess the ability of dexmedetomidine in different regimens to produce controlled hypotensive anesthesia during functional endoscopic sinus surgery in adults and the need to add an additional hypotensive agent in the form of nitroglycerin to achieve the target MAP. Methods In this blinded randomized controlled trail, 45 Patients, aged from 18 to 50 years, ASA physical status I and II, underwent endoscopic sinus surgery were enrolled in the study. Before induction of GA, all patients received bolus dexmedetomidine 1 μ/kg iv more than 10 min. After induction, Patients were randomly allocated into three groups, group Dex-0.4, in which patients received dexmedetomidine infusion as 0.4 μg/kg/h, group Dex-0.8, in which patients received dexmedetomidine infusion as 0.8 μg/kg/h and group Dex-P, in which patients received saline infusion. The target MAP was 55–65 mmHg, if not achieved by the infused study drug, nitroglycerin infusion was added in a titrating manner started with 0.1 μg/kg/min and increased gradually till the target MAP is reached. The surgical field quality was assessed by using Fromme et al. bleeding score. Results The intraoperative MAP in group Dex-P and group Dex-0.8 was maintained within target range at all time intervals. In group Dex-0.4, the MAP showed fluctuation to fall below and increased above the target range at different time intervals. Unlike the other two groups, no nitroglycerin infusion was needed in group Dex-0.8. Fromme et al. bleeding score showed the lowest values in Dex-0.8 group and the highest values in group Dex-0.4. The differences between the three groups were statistically significant with ( P 0.05). Conclusion Dexmedetomidine as bolus 1 μg/kg iv followed by iv infusion of 0.8 μg/kg/h or dexmedetomidine as pre-induction bolus 1 μg/kg iv followed by nitroglycerine iv infusion significantly decreased the mean arterial blood pressure to target values and provide satisfactory field quality.
机译：背景技术本研究旨在评估在成人成人功能性内窥镜鼻窦手术期间，右美托咪定在不同方案下产生受控降压麻醉的能力，以及是否需要以硝酸甘油形式添加其他降压药以实现目标MAP。方法该研究纳入了45例年龄在18至50岁，ASA身体状态为I和II，接受内窥镜鼻窦手术的患者。在诱导GA之前，所有患者均在10分钟内静脉推注右美托咪定1μ/ kg。诱导后，患者被随机分为三组：Dex-0.4组，其中右美托咪定输注量为0.4μg/ kg / h，Dex-0.8组，其中右美托咪定输注量为0.8μg/ kg / h，和Dex-P，患者接受生理盐水输注。目标MAP为55-65 mmHg，如果输注的研究药物未能达到，则以0.1μg/ kg / min的滴定方式添加硝酸甘油输注，并逐渐增加直至达到目标MAP。手术现场质量通过使用Fromme等进行评估。出血评分。结果Dex-P组和Dex-0.8组的术中MAP在所有时间间隔均保持在目标范围内。在组Dex-0.4中，MAP在不同的时间间隔显示出低于目标范围的波动并增加至目标范围之上。与其他两组不同，Dex-0.8组不需要硝化甘油输注。 Fromme等。出血评分在Dex-0.8组最低，在Dex-0.4组最高。三组之间的差异具有统计学意义（P <0.05）。结论右美托咪定静脉推注1μg/ kg，然后静脉输注0.8μg/ kg / h或右美托咪定静脉推注1μg/ kg静脉注射，然后硝酸甘油静脉输注，显着降低了平均动脉血压至目标值，并提供令人满意的现场质量。

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