Effect of Dexmedetomidine on Systemic Vascular Resistance in Patients Undergoing Cardiopulmonary Bypass_West China Medical Journal

Authors：

 LAIQing-li ,  HEWei , YUANQing-hui , LIWei , XIAQing , YANGTian-feng

Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding?author：

HEWei, Email: hewei5413@163.com

Keywords：

Dexmedetomidine; Cardiopulmonary bypass; Vascular resistance

DOI：

10.7507/1002-0179.20140461

Video：

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Objective To investigate the effect of dexmedetomidine on systemic vascular resistance in patients undergoing cardiopulmonary bypass. Methods Thirty-one patients undergoing cardiac surgery with cardiopulmonary bypass from January to April, 2012 were randomized into experimental group (n=16) and control group (n=15). The flow rate was kept at 2.4 L/(min·m²) and moderate hypothermia was maintained. Equivalent dexmedetomidine and 0.9% sodium chloride solution were pumped for the experimental group and control group, respectively. The mean artery pressure (MAP), systemic vascular resistance (SVR), Cortisol, epinephrine and norepinephrine were determined before (T₀) and at 10 and 20 minutes (T₁,T₂) after dexmedetomidine administration. Results Compared with T₀, there were significant decreases in MAP and SVR at T₁ and T₂ (P<0.05). MAP and SVR were significantly lower in the experimental group than in the control group at T₁ and T₂, respectively (P<0.05); cortisol, epinephrine and norepinephrine were significantly lower in the experimental group than in the control group at T₁ and T₂, respectively (P<0.05). Conclusion Dexmedetomidine reduces SVR and causes decrease in MAP. It can effectively inhibit the stress reaction in patients undergoing cardiopulmonary bypass.

Citation： LAIQing-li, HEWei, YUANQing-hui, LIWei, XIAQing, YANGTian-feng. Effect of Dexmedetomidine on Systemic Vascular Resistance in Patients Undergoing Cardiopulmonary Bypass. West China Medical Journal, 2014, 29(8): 1504-1507. doi: 10.7507/1002-0179.20140461 Copy

1.	鄭銘陟, 李李. 七氟醚吸入麻醉在體外循環轉流期間對機體應激和血流動力學的影響[J]. 醫學臨床研究, 2013, 30(2):371-373.
2.	姚倩娟, 何小京, 張良彬. 舒芬太尼和芬太尼復合麻醉下體外循環先天性心臟病手術患兒應激反應的比較[J]. 中華麻醉學雜志, 2009, 29(10):881-884.
3.	王新利. 體外循環誘發急性心肌胰島素抵抗的研究新進展[J]. 中國體外循環雜志, 2011, 9(2):118-120.
4.	林鵬燾, 魏蔚, 李堅, 等. 瑞芬太尼對體外循環患者體循環阻力的影響[J]. 中華麻醉學雜志, 2007, 27(8):677-680.
5.	Kamibayashi T, Maze M. Clinical uses of a2-Adrenergic agonists[J]. Anesthesiology, 2000, 93(5):1345-1349.
6.	胡憲文, 張野, 孔令鎖, 等. 不同劑量右美托咪啶抑制氣管插管誘發患者心血管反應效應的比較[J]. 中華麻醉學雜志, 2010, 30(11):1304-1306.
7.	陳章玲, 曹德權, 徐軍美, 等. 右美托咪啶臨床應用新進展[J]. 廣東醫學, 2012, 33(2):290-292.
8.	龍村. 體外循環學[M]. 北京:人民軍醫出版社, 2004:104-105.
9.	蔣洪宇, 申穎, 劉兵. 小兒紫紺型心臟病矯治術的麻醉及體外循環管理[J]. 廣東醫學, 2008, 29(8):1348-1349.
10.	劉正美, 杭燕南. 尼卡地平和硝酸甘油在體外循環中血壓控制的比較[J]. 上海醫學, 2001, 24(1):26-28.
11.	趙洪偉, 王強, 魏偉, 等. 體外循環中尼卡地平和硝酸甘油控制血壓效果及對血流動力學參數的影響[J]. 齊魯醫學雜志, 2006, 21(5):415-416, 418.
12.	姚莉, 周小妹, 趙晶晶. 右美托咪啶在重癥監護病房應用的研究[J]. 中國危重病急救醫學, 2010, 22(10):632-634.
13.	吳新民, 許幸, 王俊科, 等. 靜脈注射右美托咪啶輔助全身麻醉的有效性和安全性[J]. 中華麻醉學雜志, 2007, 27(9):773-776.
14.	李民, 張利萍, 吳新民. 右美托咪啶在臨床麻醉中應用的研究進展[J]. 中國臨床藥理學雜志, 2007, 23(6):466-470.
15.	Shehabi Y, Ruettimann U, Adamson H, et al.dexmedetomidine infusion for more than 24 hours in critically ill patients:gedelive and cardiovaseular effects[J]. Intensive Care Med, 2004, 30(12):2188-2196.
16.	Klamt JG, Vicente WV, Garcia LV, et al. Hemodynamic effects of the combination of dexmedetomiding-fentanyl versus midazolam-fentanyl in children undergoing cardiac surgery with cardiopulmonary bypass[J]. Rev Bras Anestesiol, 2010, 60(4):336-350.
17.	尹毅青, 羅愛倫, 郭向陽, 等. 冠狀動脈搭橋術患者圍手術期皮質醇晝夜分泌節律與神經心理狀態的研究[J]. 中華外科雜志, 2005, 43(7):463-467.
18.	Aho M, Scheinin M, Lehtinen AM, et al. Intramuscularly administered dexmedetomidine attenuates hemodynamic and stress hormone responses to gynecologic laparoscopy[J]. Anesth Analg, 1992, 75(6):932-939.

1. 鄭銘陟, 李李. 七氟醚吸入麻醉在體外循環轉流期間對機體應激和血流動力學的影響[J]. 醫學臨床研究, 2013, 30(2):371-373.
2. 姚倩娟, 何小京, 張良彬. 舒芬太尼和芬太尼復合麻醉下體外循環先天性心臟病手術患兒應激反應的比較[J]. 中華麻醉學雜志, 2009, 29(10):881-884.
3. 王新利. 體外循環誘發急性心肌胰島素抵抗的研究新進展[J]. 中國體外循環雜志, 2011, 9(2):118-120.
4. 林鵬燾, 魏蔚, 李堅, 等. 瑞芬太尼對體外循環患者體循環阻力的影響[J]. 中華麻醉學雜志, 2007, 27(8):677-680.
5. Kamibayashi T, Maze M. Clinical uses of a2-Adrenergic agonists[J]. Anesthesiology, 2000, 93(5):1345-1349.
6. 胡憲文, 張野, 孔令鎖, 等. 不同劑量右美托咪啶抑制氣管插管誘發患者心血管反應效應的比較[J]. 中華麻醉學雜志, 2010, 30(11):1304-1306.
7. 陳章玲, 曹德權, 徐軍美, 等. 右美托咪啶臨床應用新進展[J]. 廣東醫學, 2012, 33(2):290-292.
8. 龍村. 體外循環學[M]. 北京:人民軍醫出版社, 2004:104-105.
9. 蔣洪宇, 申穎, 劉兵. 小兒紫紺型心臟病矯治術的麻醉及體外循環管理[J]. 廣東醫學, 2008, 29(8):1348-1349.
10. 劉正美, 杭燕南. 尼卡地平和硝酸甘油在體外循環中血壓控制的比較[J]. 上海醫學, 2001, 24(1):26-28.
11. 趙洪偉, 王強, 魏偉, 等. 體外循環中尼卡地平和硝酸甘油控制血壓效果及對血流動力學參數的影響[J]. 齊魯醫學雜志, 2006, 21(5):415-416, 418.
12. 姚莉, 周小妹, 趙晶晶. 右美托咪啶在重癥監護病房應用的研究[J]. 中國危重病急救醫學, 2010, 22(10):632-634.
13. 吳新民, 許幸, 王俊科, 等. 靜脈注射右美托咪啶輔助全身麻醉的有效性和安全性[J]. 中華麻醉學雜志, 2007, 27(9):773-776.
14. 李民, 張利萍, 吳新民. 右美托咪啶在臨床麻醉中應用的研究進展[J]. 中國臨床藥理學雜志, 2007, 23(6):466-470.
15. Shehabi Y, Ruettimann U, Adamson H, et al.dexmedetomidine infusion for more than 24 hours in critically ill patients:gedelive and cardiovaseular effects[J]. Intensive Care Med, 2004, 30(12):2188-2196.
16. Klamt JG, Vicente WV, Garcia LV, et al. Hemodynamic effects of the combination of dexmedetomiding-fentanyl versus midazolam-fentanyl in children undergoing cardiac surgery with cardiopulmonary bypass[J]. Rev Bras Anestesiol, 2010, 60(4):336-350.
17. 尹毅青, 羅愛倫, 郭向陽, 等. 冠狀動脈搭橋術患者圍手術期皮質醇晝夜分泌節律與神經心理狀態的研究[J]. 中華外科雜志, 2005, 43(7):463-467.
18. Aho M, Scheinin M, Lehtinen AM, et al. Intramuscularly administered dexmedetomidine attenuates hemodynamic and stress hormone responses to gynecologic laparoscopy[J]. Anesth Analg, 1992, 75(6):932-939.

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Effect of Dexmedetomidine on Systemic Vascular Resistance in Patients Undergoing Cardiopulmonary Bypass

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