右旋美托咪啶在全麻诱导中对脑电双频谱及血流动力学指数的影响

EFFECT OF DEXMEDETOMIDINE ON ELECTROENCEPHALIC BISPECTRAL AND HEMODYNAMIC INDEX DURING INDUCTION OF GENERAL ANESTHESIA

目的探讨右旋美托咪啶在全麻诱导中对脑电双频谱及血流动力学指数的影响。方法选择全麻下神经外科择期手术病人40例(ASAⅠ或Ⅱ级),随机分为咪达唑仑组(M组)和右旋美托咪啶组(D组)。分别给予咪达唑仑及右旋美托咪啶+咪达唑仑麻醉。分别记录病人入麻醉室时(T0)、诱导后5min(T1)、诱导后10min(T2)、插管即刻(T3)以及插管后1min(T4)、2min(T5)、5min(T6)的心率(HR)、收缩压(SBP)、舒张压(DBP)和脑电双频谱指数(BIS)值。结果 D组T1、T2时刻BIS值显著低于M组(t=4.22、6.80,P<0.05),气管插管后两组BIS值比较差异无显著性(P>0.05)。与M组相比,D组气管插管后T4、T5时刻HR、SBP明显低于M组(t=2.14～4.11,P<0.05)。结论 0.5μg/kg右旋美托咪啶全麻诱导中可明显降低BIS值,用于神经外科病人全麻诱导较单用咪达唑仑组血流动力学指数更稳定。

Objective To investigate the effect of Dexmedetomidine on electroencephalic bispectral and hemodynamic index during induction of general anesthesia.Methods Forty patients（ASA Ⅰ-Ⅱ） undergoing elective neurosurgery under ge-neral anesthesia were enrolled and randomized to midazolam group（group M） and dexmedetomidine group（group D）.The patients in the two groups were given midazolam and dexmedetomidine plus midazolam,respectively.The BIS,heart rate（HR）,systolic blood pressure（SBP）and diastolic blood pressure（DBP） were recorded before induction（T0）,5 min（T1） and 10 min（T2） after induction,immediately after tracheal intubation（T3） and 1 min（T4）,2 min（T5） and 5 min（T6） after intubation.ResultsThe BIS of group D was significantly lower than that in group M at T1 and T2（t=4.22,6.80;P〈0.05）,but its difference between the two groups was not significant after intubation（P〉0.05）.Compared with group M,HR and SBP of group D decreased significantly at T4,T5 after intubation（t=2.14-4.11,P〈0.05）.Conclusion The use of 0.5 μg/kg of dexmedetomidine at induction of general anesthesia can markedly reduce the BIS values,which is better than using midazolam alone in maintaining a stable hemodynamic index for neurosurgical patients undergoing surgery.