右美托咪啶用于行神经外科手术的高血压患者全身麻醉拔管期的有效性和安全性

Effectiness and safety dexmedetomidine during extubation period of general anesthesia in hypertension patients receiving neurosurgery

目的探讨右美托咪啶用于行神经外科手术的高血压患者全身麻醉拔管期的有效性和安全性。方法选择44例行神经外科手术的高血压患者,随机分成右美托咪啶(D)组和0.9%氯化钠溶液(N)组,每组22例,分别于手术结束前30 min给药,记录诱导前、注射药物前、拔除气管导管时,以及拔除气管导管后1、5、10 min时的平均动脉压(MAP)、心率(HR),记录苏醒时间及苏醒后30 min时的疼痛视觉模拟(VAS)评分。结果与注射药物前比较,D组MAP、HR较平稳,在各时间点的差异均无统计学意义(P值均>0.05)。N组拔除气管导管时及拔除气管导管后1、5、10 min时的MAP、HR均较注射药物前以及D组同时间点显著升高(P值分别<0.05、0.01)。D组的疼痛VAS评分显著低于N组(P<0.05)。D组与N组苏醒时间的差异无统计学意义(P>0.05)。结论右美托咪啶应用于在全身麻醉下行神经外科手术的高血压患者,可有效维持呼吸、循环稳定,全面减少拔管期患者的不良反应,且不影响患者的清醒。

Objective To investigate the effectiveness and safety of dexmedetomidine during the extubation period of general anesthesia in hypertension patients receiving neurosurgery.Methods Totally 44 hypertension patients receiving neurosurgery were randomly divided into two groups,dexmedetomidine group（D group,n = 22） and saline group（N group,n = 22）.The corresponding agents were administrated at 30 min before the end of operation.The mean artery pressure（MAP）,heart rate（HR） and visual analogue scale（VAS） were recorded before anesthesia,before drugs injection,during extubation and at 1min,5min,and 10min after extubation.Results In the D group,MAP and HR were similar at each time point compared to those of preanesthesia. In the N group,MAP and HR were significantly higher at extubation,and 1,5,and 10 after extubation compared to those of pre-injection and those in the D group（P0.01 or 0.05）.The VAS score of D group was significantly lower than that in N group（P0.05）.There was no significant difference in the awakening time between the two groups（P0.05）.Conclusions Dexmedetomidine can stabilize respiration and circulation during extubation period of general anesthesia in hypertension patients receiving neurosurgery,reducing the adverse reaction of extubation period,without influencing the awakening of patients.