硬膜外美托咪啶对单肺通气胸外科手术的影响

Influences of epidural dexmedetomidine on thoracic surgery with one-lung ventilation

目的:探讨胸段硬膜外美托咪啶对单肺通气的胸外科术后患者术中知晓和术后疼痛的影响。方法:将50例择期开胸手术患者随机分为A、B两组,其中A组为美托咪啶复合罗哌卡因,B组为罗哌卡因。术中记录血流动力学,脑电双频指数(BIS),术后采用视觉模拟评分(VAS)记录疼痛评分,及第1天、第4天询问有无术中知晓。结果:A组在OLV-10,OLV-30的BIS值显著低于B组,B组有较高的VAS评分,且2例怀疑有术中知晓。结论:在单肺通气的胸外科手术中,硬膜外美托咪啶应用可显著减少镇痛药物的需要,防止术中知晓,改善术后疼痛。

Objective To study the influences of epidural dexmedetomidine on intraoperative awareness and post-operative pain in thoracic surgery with one-lung ventilation（OLV）.Methods 50 cases of thoracic surgery were randomly divided into A、B two groups.A group was dexmedetomidine with ropivacaine and B group was ropivacaine alone.Intraoperative haemodynamic and bispectral index values （BIS） were recorded.Post-operative visual analogue score （VAS） for pain and intraoperative awareness was queried on 1 day,4 day.Results The BIS in A group was significantly lower B group in OLV-10 and OLV-30.B group had higher VAS scores and two patients in group B reported possible intraoperative awareness.Conclusion In thoracic surgery with OLV,the use of epidural dexmedetomidine decreases the anaesthetic requirements significantly,prevents intraoperative awareness and improves post-operative analgesia.