评估Propofol和Dexmedetomidine在ENT手术中用于低压麻醉的效率
P Kamesh Chandra1, Dinesh Kumar Patel2, Ranjeet Kumar Mohanty3
1Department of Anaesthesiology and Critical Care, KIMS Seethammadhara, Visakhapatnam, Andhra Pradesh, India.
Journal of pharmacy & bioallied sciences
|July 14, 2025
概括
与普罗波相比,德克斯梅德托米丁改善了手术视力,并在ENT手术期间减少了血液损失. 虽然对受控的低血压有效,但德克斯梅德托米丁可能会稍微延长恢复时间.
科学领域:
- 麻醉学 麻醉学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 低血压麻醉对于耳鼻门手术至关重要,以改善手术视力并最大限度地减少血液损失.
- 德克斯梅德托米丁和普罗波是常见的麻醉剂,具有不同的作用机制.
- 这项研究评估了它们在ENT手术期间实现受控低血压的有效性.
研究的目的:
- 为了比较德克斯梅德托米丁与普罗波在选择性耳鼻喉手术中控制低血压的有效性.
- 评估这些药物对血液动力学参数,手术现场质量,血液损失和恢复时间的影响.
主要方法:
- 一项前性随机临床研究,涉及60名接受选择性耳鼻喉手术的成年患者.
- 患者被随机分配,接受普罗波福 (A组) 或德克斯梅德托米丁 (B组) 输液.
- 进行了血液动力学监测 (HR,MAP),视觉模拟尺度 (VAS) 进行手术现场质量,血液损失评估和恢复期评估.
主要成果:
- 与普罗波 (A组,65 ± 5 mmHg) 相比,德克斯梅德托米丁组 (B组) 的平均动脉压 (60 ± 4 mmHg) 较低 (P < 0.05).
- B组的外科实地质量明显改善 (VAS 8.5 ± 0.7 与 7.8 ± 0.9 相比,P = 0.01) 并且血液损失减少了 15% (P = 0.04).
- 心率相似 (A组:每分钟72±8;B组:每分钟68±6,P=0.03),康复时间略长,但在B组没有统计学意义 (12±3分钟对10±2分钟,P=0.08).
结论:
- 在ENT手术中,德克斯梅德托米丁在控制低血压方面优于普罗波,提供了更好的外科实地质量和减少血液损失.
- 尽管潜在的恢复时间稍长,但德克斯梅德托米丁在这种手术环境中是低血压麻醉的有价值剂.
- 这些发现支持使用德克斯梅德托米丁来优化需要控制低血压的耳鼻喉手术的结果.
相关概念视频
Parenteral Anesthetics: Overview
202
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
202
General Anesthesia: Overview
286
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
286
Stages of General Anesthesia
724
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
724
Inhalational Anesthetics: Overview
525
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
525
Sedatives and Hypnotics Drugs: Miscellaneous Agents
245
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
245
Depolarizing Blockers: Pharmocokinetics
384
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
384


