摘要
目的观察右美托咪定抑制颅脑手术患者拔管反应的临床效果。方法 60例行开颅手术患者随机分成2组,所有患者在手术结束前30min静脉推注(>10min)右美托咪定0.5μg/kg(DEX组)或0.9%氯化钠注射液(NS组)。分别记录患者诱导前(T0)、入麻醉后恢复室(PACU)即刻(T1)、拔管即刻(T2)和拔管后5min(T3)的收缩压(SBP)、舒张压(DBP)、心率(HR)和脉搏血氧饱和度(SpO2),相应计算出拔管前后血流动力学变化差值(△SBP、△DBP、△HR),抽取相应时段血液测定血浆肾上腺素(AD)及去甲肾上腺素(NE)浓度,并记录2组患者拔管反应发生率。结果同NS组比较,DEX组T2、T3时SBP、DBP、HR、血浆AD及NE浓度明显低于NS组(P<0.05);同NS组比较,DEX组SBPmax、DBPmax、HRmax及△SBP、△DBP、△HR降低(P<0.05);同NS组拔管反应(67%)比较,DEX组发生率(10%)明显降低(P<0.05)。结论右美托咪定用于颅脑手术患者可以抑制拔管期间心血管反应,减轻拔管反应,具有良好的临床效果。
Objective To observe the efficacy of dexmedetomidine（DEX） during endotracheal extubation in craniocerebral surgery.Methods Sixty patients undergoing craniotomy were randomized into two groups.Thirty mins before the surgery,dexmedetomidine at a dose of 0.5 μg/kg in group DEX（n=30） and saline in group NS（n=30） were administrater intravenously over 10 min.SBP,DBP,HR and SpO2 were recorded at different time（before induction,at the time to PACU,at the time of extubation and 2 mins after extubation）.Then △SBP,△DBP and △HR were calculated.We also recorded the level of AD and NE for each time.Results Compared with NS group,DEX group had much lower change in SBPmax,DBPmax,HRmax,△SBP,△DBP,△HR,AD and NE at time T2,T3（P0.05）.The incidence of extubation reaction in DEX group（10%） was also lower than that in NS group（67%）（P0.05）.Conclusion General anesthesia using dexmedetomidine in craniocerebral surgery could decrease the fluctuation of hemodynamics and depress extubation reaction.
基金
辽宁省教育厅基金(2008796)
关键词
右美托咪定
颅脑手术
拔管反应
Dexmedetomidine
Craniocerebral surgery
Extubation reaction
