鼻内右美托咪定对双腔支气管插管期间血流动力学反应的影响：一项随机对照试验
The Effect of Intranasal Dexmedetomidine on Hemodynamic Responses during Double-Lumen Tube Insertion: A Randomized Controlled Trial.
文献信息
| PMID | 42862665 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Roys P Gilbert |
| 作者单位 | Department of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India. |
| 期刊 | Annals of cardiac anaesthesia |
| SCI 分区 | Q3 |
| IF | 1.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 胸科手术需要控制性肺塌陷以获得最佳视野，这通过双腔支气管（DLT）插管实现单肺通气（OLV）。DLT插入会触发显著的交感神经激活，可能导致心血管并发症和脑血管事件。本研究旨在探讨鼻内给予右美托咪定在减轻喉镜检查和DLT置入相关血流动力学波动方面的疗效。
方法： 这项随机对照研究在南印度的一家三级医疗中心进行。招募需要DLT插入的胸科手术患者，并随机分为A组和B组（n = 25）。A组在麻醉诱导前45分钟通过黏膜雾化装置接受1 mcg/kg鼻内右美托咪定，B组接受鼻内生理盐水。记录插管后长达30分钟的不同时间点的血流动力学参数，包括收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）和心率（HR）。
结果： 右美托咪定组患者插管前心率（84.92 ± 0.0349）低于安慰剂组（96.48 ± 0.0349）。A组在插管时（T0）及后续时间点（T1、T2、T3、T20、T25和T30）观察到心率统计学显著降低。插管前SBP和DBP下降，之后的读数显示出统计学显著差异（P = 0.000）。A组患者需要显著更少的丙泊酚来维持血压在基线20%以内。
结论： 在诱导前单次给予1 mcg/kg鼻内右美托咪定可有效管理喉镜检查期间的血流动力学反应。
英文摘要
BACKGROUND: Thoracic surgeries require controlled lung collapse for optimal visualization, achieved through Double-Lumen Tube (DLT) intubation for one-lung ventilation (OLV). DLT insertion triggers significant sympathetic activation, potentially causing cardiovascular complications and cerebrovascular events. This study aimed to investigate the efficacy of intranasally administered Dexmedetomidine in attenuating hemodynamic perturbations associated with laryngoscopy and DLT placement.
METHODS: This randomized controlled study was done in a tertiary care center in South India. Patients coming for thoracic surgery requiring DLT insertion were recruited and randomized into Group A and Group B (n = 25). Group A received 1 mcg/kg Intranasal Dexmedetomidine, and Group B received Intranasal Normal saline 45 minutes prior to induction of anaesthesia using a mucosal atomizer device. Hemodynamic parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR), were recorded at different time points up to 30 minutes after intubation.
RESULTS: Patients in the dexmedetomidine group had a lower heart rate before intubation (84.92 ± 0.0349) than those in the placebo group (96.48 ± 0.0349). A statistically significant reduction in heart rate was observed in Group A at intubation (T0) and at subsequent time points (T1, T2, T3, T20, T25, and T30). SBP and DBP decreased before intubation, after which subsequent readings showed a statistically significant difference (P = 0.000). Patients in Group A required significantly less Propofol to maintain BP within 20% of baseline.
CONCLUSION: Administering a single dose of intranasal dexmedetomidine at 1 mcg/kg before induction effectively manages the hemodynamic response during laryngoscopy.