本文中右美托咪定配成4 μg/mL浓度,以1 μg/kg剂量注射泵匀速泵入,数分钟后出现窦性心动过缓,较输注前下降30%,停药后心率恢复,减量后再次泵入,心率再次下降,
通过本例患者,笔者的临床体会一是在应用此药时,必须选择合适的患者,对低血容量、心脏传导阻滞、心室功能异常和老年患者要慎用;二是注意输注的剂量和输注速度,密切监测心率、血压、血氧饱和度等指标,尤其在输注的前30 min;三是发生心动过缓时可减慢输注速度或停止用药,必要时静脉应用阿托品等药。在临床试验中格隆溴铵或阿托品治疗盐酸右美托咪定诱发的心动过缓是有效的[6]。
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(收稿日期:2011-10-14 本文编辑:郝明明), 百拇医药(王志 刘野 金波)