右美托咪定对强直性脊柱炎后路矫形术中唤醒试验的影响

Effects of dexmedetomidine on intraoperative wake-up test in patients with ankylosing spondylitis undergoing posterior osteotomy

目的探讨右美托咪定对强直性脊柱炎(AS)后路矫形术中唤醒试验的影响。方法 28例行AS后路矫形术的患者随机均分为两组。麻醉诱导前10min,D组静脉泵注右美托咪定0.8μg/kg,以0.2μg·kg-1·h-1维持至唤醒试验开始前10min;R组给予等体积生理盐水。唤醒试验开始前两组均停用所有麻醉用药。记录术前(T0)、唤醒试验开始时(T1)和唤醒时(T2)患者的平均动脉压(MAP)、心率(HR)和脑电双频指数(BIS);记录唤醒时间和唤醒质量评级。结果 T1时两组MAP和HR相仿,T2时D组MAP和HR低于R组(P<0.05)。与R组比较,D组唤醒时间短,唤醒质量高(P<0.05)。结论右美托咪定用于AS后路矫形术中,唤醒试验的唤醒时间短、唤醒质量高,唤醒期间血流动力学稳定。

Objective To observe the effects of dexmedetomidine on intraoperative wake-up test in the patients with ankylosing spondylitis（AS）undergoing posterior osteotomy.Methods Twentyeight patients with AS undergoing posterior osteotomy were equally randomized into 2 groups.The patients in group D were injected dexmedetomidine 0.8 μg/kg at 10 min before induction,which was followed by an infusion of dexmedetomidine 0.2 μg·kg^-1·h^-1 until 10 min before wake-up test.Normal saline was given in group R as the control.The anesthetic drugs for the maintenance were stopped before wake-up test.The values of MAP,HR and bispectral index were recorded at the time points of preinduction（T0）,just before wake-up test（T1）and awakening（T2）.The wake-up quality score and wake-up time were recorded.Results There were no significant differences in MAP and HR at T1 between two groups.MAP and HR at T2 were lower in group D than those in group R（P〈0.05）.The wake-up quality was better in group D than that in group R（P〈0.05）.The wake-up time was less in group D than that in group R（P〈0.05）.Conclusion Dexmedetomidine can shorten the wake-up time,improve the wake-up quality and keep hemodynamics stable in the patients with AS undergoing posterior osteotomy.