大理大学学报 ›› 2025, Vol. 10 ›› Issue (8): 62-66.DOI: 10. 3969 / j. issn. 2096-2266. 2025. 08. 009

• 临床医学 • 上一篇    下一篇

右美托咪定滴鼻在老年患者全身麻醉术中的应用

原见春1,曹 波2,苏丽红1,周 云1*   

  1. (1. 玉溪市人民医院麻醉科,云南玉溪 653100; 2. 玉溪市中医医院急诊科,云南玉溪 653100)
  • 收稿日期:2024-04-29 修回日期:2024-12-17 出版日期:2025-08-15 发布日期:2025-09-06
  • 通讯作者: 周云,副主任医师,E-mail:904357572@qq.com。
  • 作者简介:原见春,主治医师,主要从事老年患者麻醉及心血管麻醉研究。

Application of Intranasal Dexmedetomidine in General Anesthesia for Elderly Patients

Yuan Jianchun1, Cao Bo2, Su Lihong1, Zhou Yun1*   

  1. (1. Department of Anesthesiology, People's Hospital of Yuxi City, Yuxi, Yunnan 653100, China; 2. Department of Emergency,
    Yuxi Municipal Hospital of T.C.M., Yuxi, Yunnan 653100, China)
  • Received:2024-04-29 Revised:2024-12-17 Online:2025-08-15 Published:2025-09-06

摘要: 目的:探讨不同给药剂量右美托咪定滴鼻在老年患者全身麻醉术中的应用。方法:将2023年1月至2023年9月在玉溪市
人民医院择期行全身麻醉手术的60例老年患者纳入研究,随机分为A组(给药剂量为0.5 μg/kg)、B组(给药剂量为0.8 μg/kg)
和C组(给药剂量为1.0 μg/kg),每组20例,各组患者均在麻醉诱导前30 min使用右美托咪定滴鼻。比较3组患者各时间点平
均动脉压(MAP)、心率(HR)及心率-血压乘积(RPP),以及唤醒时间、拔管时间、麻醉后监测治疗室(PACU)留观时间、拔管质
量评分、Ramsay等级及心率减慢情况等。结果:A组患者在诱导插管和气管拔管时的MAP、HR和RPP波动较大,且拔管时出
现呛咳等不良反应。B组和C组的生命体征较平稳,拔管质量评分较高,C组的Ramsay等级显著高于A组和B组,但C组患者
术后出现嗜睡情况,PACU留观时间延长。结论:对于择期行全身麻醉的老年患者,麻醉诱导前30 min给予0.8 μg/kg右美托咪
定滴鼻,可有效抑制诱导插管和气管拔管时的应激反应,同时不良反应较少,适合临床麻醉中应用。

关键词: 右美托咪定滴鼻, 老年患者, 全身麻醉

Abstract: Objective: To explore the application of intranasal dexmedetomidine at different doses in elderly patients during general
anesthesia. Methods: A total of 60 elderly patients undergoing elective surgery under general anesthesia at People's Hospital of Yuxi
City from January to September 2023 were randomly divided into three groups: Group A( 0.5 μg/kg), Group B( 0.8 μg/kg), and Group C
(1.0 μg/kg), with 20 patients in each group. Intranasal dexmedetomidine was administered 30 minutes prior to anesthesia induction in all
groups. Mean arterial pressure (MAP), heart rate (HR), and rate pressure product (RPP) were measured at different time points.
Awakening time, extubation time, postanesthesia care unit (PACU) stay duration, extubation quality scores, Ramsay sedation scores,
and incidences of bradycardia were also compared. Results: In Group A, MAP, HR, and RPP were significantly increased during
induction intubation and tracheal extubation, with adverse reactions such as coughing during extubation. Groups B and C exhibited more
stable vital signs and higher extubation quality scores. Notably, the Ramsay sedation score in Group C was significantly higher than in
Groups A and B, but Group C also showed postoperative drowsiness and prolonged PACU stay. Conclusion: Administering intranasal
dexmedetomidine at 0.8 μg/kg 30 minutes prior to anesthesia induction effectively suppresses stress responses during intubation and
extubation in elderly patients undergoing elective general anesthesia. This dose demonstrates minimal adverse effects and is suitable
for clinical application in anesthesia management.

Key words: intranasal dexmedetomidine, elderly patients, general anesthesia

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