右美托咪定对神经外科手术病人麻醉苏醒期血流动力学指标影响

EFFECT OF DEXMEDETOMIDINE ON HAEMODYNAMICS AT STAGE OF ANALEPSIA IN PATIENTS UNDERGOING NEUROSURGERY

目的探讨右美托咪定(DEX)对神经外科手术病人麻醉苏醒期血流动力学指标的影响。方法选择神经外科手术病人50例,分为生理盐水对照组(C组)和DEX组(D组),诱导插管后随机泵注生理盐水或0.8μg.kg-1.h-1 DEX至硬膜完全关闭。根据脑电双频谱指数(BIS)调节丙泊酚输注速度,记录两组术前、用药前、停药后及拔管期间血压、心率以及舒芬太尼使用总量。拔管后15min内记录病人呛咳次数、氧合不足的情况。结果两组病人拔管时心率均有所上升,C组更明显(t=2.355,P<0.05)。D组拔管期血压比C组明显降低(t=4.106～4.456,P<0.05)。舒芬太尼及丙泊酚使用量C组也多于D组(t=4.605、6.591,P<0.05)。D组呛咳次数显著少于C组(u=4.000,P<0.05)。结论 DEX可明显改善神经外科手术病人麻醉苏醒期血流动力学指标的稳定性。

Objective To investigate the effect of dexmedetomidine（DEX） on haemodynamics during stage of analepsia in patients undergoing neurosurgery.Methods Fifty patients who received neurosurgical procedures were divided into control group and DEX group.After induced intubation,they were randomly allocated to either DEX 0.8 μg·kg-1·h-1 or normal saline until the endocranium was completely closed.Dosage of propofol was adjusted based on the changes of BIS value.The blood pressure,heart rate of the patients before surgery and medication,after drug withdrawal,at extubation,and total amount of sufentanil used were recorded.The frequency of bucking and under-oxygenation within 15 minutes after extubation were recorded.ResultsAt removal of tracheal tube,the heart rate of patients increased in both groups,more obviously were in the control group（t=2.355,P0.05）.The blood pressure in DEX group declined more versus the control（t=4.106-4.456,P0.05）;the dosages of sufentanil and propofol used were higher in the control than that in the DEX group（t=4.605,6.591;P0.05）.The frequency of bucking was fewer in the DEX than the control（u=4.000,P0.05）.Conclusion DEX can improve the stability of parameters of haemodynamics in patients undergoing neurosurgery during their stage of analepsia.