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【目的】比较不同剂量右美托咪定抑制喉部肿瘤手术气管切开插管诱发应激反应的效果。【方法】拟在全麻下限期行喉部肿瘤手术的患者120例，年龄40～60岁，ASAⅠ或Ⅱ级，喉阻塞Ⅰ～Ⅱ度，随机分为四组，每组30例：对照组（C组）、低、中、高剂量右美托咪定（D1～3组）。分别在气管切开插管前15 m in静脉注射15 mL生理盐水、右美托咪定02．5、05．、07．5μg／kg ，输注时间15 min。之后局麻下行气管切开插管，全麻诱导，机械通气。记录输注右美托咪定前（T0）、插管前即刻（T1）、插管成功即刻（T2）、麻醉诱导后3 min（T3）患者的心率（HR）、血压（BP）、脉搏血氧饱和度（SpO2）及气管切开插管过程中患者高血压、心动过速、体动、呛咳、呼吸抑制等不良反应事件。术后随访测评两组患者气管切开插管过程中的痛苦程度，进行舒适满意度评价。【结果】与T0时比较，C组和D1组收缩压（SBP）、舒张压（DBP）、HR在 T1～2时升高（ P ＜00．5）；T3时C组和D1～2组SBP、DBP、HR降低，D3组SBP和DBP升高（ P ＜00．5）。T1～2时，C组和D1组SBP、DBP、HR明显高于D2组（ P ＜00．1）。T1～3时D3组较D2组SBP和DBP升高（ P ＜00．5）。D2组患者高血压、心动过速、体动、呛咳等不良反应事件的发生明显减少，D2组舒适满意度高于C组和D1组。所有患者均未发生呼吸抑制。【结论】静脉输注右美托咪定达05．μg／kg时，可显著抑制伤害性刺激诱发的不良应激反应，且无明显呼吸抑制。“,”Objective]To compare the effects of different doses of dexmedetomidine in inhibition of stress response to tracheal incision and intubation undergoing laryngeal tumor surgery [.Methods]One hundred and twenty ASA Ⅰ or Ⅱ patients ,aged 40~60 yr ,scheduled for laryngeal tumor surgery ,were randomly as‐signed to 4 groups ( n =30 each):placebo group (group C);low ,median and high doses of dexmedetomidine groups (group D1~3 ) .In group D1~3 ,15 min before tracheotomy ,dexmedetomidine 0 2.5 ,0 5. and 0 7.5 μg/kg 15 mL were infused over 15 min respectively ,while normal saline was given instead in the same volume in group C .After trcheal incision and intubation ,anesthesia induction was performed and the patients were me‐chanically ventilated .BP ,HR and SpO2 were recorded before infusion of dexmedetomidine (T0 ) ,before intu‐bation (T1 ) ,immediately after intubation (T2 ) ,and at 3min after intubation (T3 ) .Intraoperative body move‐ment ,cough ,cardiovascular adverse reactions and respiration depression were recorded .[Results]Compared with T0 ,SBP ,DBP ,HR at T1~2 in group C and D1 were increased ,whereas those at T3 in group C and D1~2 were decreased and BP in D3 increased ( P <0 0.5) .SBP ,DBP and HR at T1~2 in group C were significantly higher than in group D2 ( P <0 0.5) .BP at T1~3 in group D3 was higher than in group D2 ( P <0 0.5) .The inci‐dence of hypertension ,trachycardia ,body movement and cough were significantly decreased in group D2 .No respiration depression happened in all patients .Compared with group C and D1 ,the patients in group D2 felt more comfortable and satisfied .[Conclusion]When the dose of dexmedetomidine reaches 0 5.μg/kg ,it may ef‐fectively inhibit the adverse stress reaction to harmful stimulation with no respiration depression .