右美托咪定、硫酸镁与利多卡因对腹腔镜妇科手术中喉镜插管升压反应及视神经鞘直径影响的比较研究

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中文摘要

背景： 全身麻醉中使用喉镜和插管可引起高血压和心动过速等应激反应。已使用静脉（IV）右美托咪定、硫酸镁（MgSO4）和利多卡因比较它们对升压反应、血流动力学和视神经鞘直径（ONSD）的影响。
方法： 102名拟在全身麻醉下接受择期妇科腹腔镜手术的女性患者参与了这项随机、双盲研究。她们被随机分配接受静脉右美托咪定（D组，n = 34）、静脉硫酸镁（M组，n = 34）或静脉利多卡因（L组，n = 34）。在用药前和用药后、麻醉诱导前和诱导后、插管后（套囊充气（1分钟））以及插管后5分钟和10分钟评估心率（HR）和平均动脉压。在同一时间点进行ONSD测量。
结果： 插管后1分钟（套囊充气）时，与M组和L组相比，D组HR最低，且D组和M组的平均血压（MBP）低于L组。插管后5分钟和10分钟时，D组HR低于M组和L组，且D组MBP低于M组和L组。插管后1、5和10分钟时，D组ONSD低于M组和L组。
结论： 与静脉MgSO4和利多卡因相比，静脉右美托咪定在喉镜插管期间对血流动力学和ONSD反应的控制最佳。

英文摘要

BACKGROUND: The use of laryngoscope and intubation in general anesthesia can cause stress response like hypertension and tachycardia. Intravenous (IV) dexmedetomidine, magnesium sulfate (MgSO4), and lidocaine have been used to compare their effect on pressor response, hemodynamics, and optic nerve sheath diameter (ONSD).
METHODS: One hundred and two female patients slated for elective gynecologic laparoscopic surgery under general anesthesia were involved in this randomized, double-blinded study. They were randomized to receive IV dexmedetomidine (Group D, n = 34), IV magnesium SO4 (Group M, n = 34), or IV lidocaine (Group L, n = 34). Heart rate (HR) and mean arterial pressure were assessed prior to and following medication usage, prior to and following the induction of anesthesia, following intubation (cuff inflation (1 minute), and 5 and 10 minutes following intubation. At the same timeframe, the ONSD measurement was conducted.
RESULTS: After intubation for 1 min (cuff inflation), Group D had the lowest HR compared to groups M and L and also Mean blood pressure (MBP) was lower in group D and group M than group L. At 5 min and 10 min after intubation, HR was lower in group D than group M and group L and MBP was lowest in group D than group M and group L. ONSD was lower in group D than group M and group L at 1, 5, and 10 min after intubation.
CONCLUSIONS: IV dexmedetomidine offers the best control on hemodynamics and ONSD responses during laryngoscopic intubation than IV MgSO4 and lidocaine.