盐酸右美托咪定用于立体定向颅内血肿微创抽吸术的麻醉效果

Dexmedetomidine Anaesthesia for Stereotactic Hematoma Aspiration in Treating Cerebral Hemorrhage

目的:探讨盐酸右美托咪定用于立体定向颅内血肿微创抽吸术治疗脑出血的麻醉效果。方法:高血压脑出血患者69例,随机分为观察组34例及对照组35例。2组术前麻醉时均先静脉注射芬太尼1μg/kg,对照组采用常规麻醉方法,观察组采用盐酸右美托咪定进行麻醉,记录患者进入手术室(T1)、应用丙泊酚或盐酸右美托咪定后(T2)、安置头架后(T3)、钻孔时(T4)时的平均动脉压(MAP)、氧分压(PaO2)、二氧化碳分压(PaCO2),并比较2组出现的不良反应。结果:与对照组比较,观察组心率在T3、T4时间明显降低,PaO2明显升高,差异有统计学意义(P<0.05),MAP、PaCO2在T4时间差异有统计学意义(P<0.05)。观察组术中低血压、心动过速、躁动及术后呕吐发生人数低于对照组,差异有统计学意义(P<0.05)。结论:盐酸右美托咪定用于立体定向颅内血肿微创抽吸术治疗脑出血的麻醉效果较丙泊酚好良好,心率、MAP、PaO2波动小,呼吸抑制较少。

Objective：To investigate the effect of dexmedetomidine anaesthesia on stereoscopic hematoma aspira-tion in treating cerebral hemorrhage. Methods： Sixty-nine patients with hypertensive cerebral hemorrhage were randomly divided into the observation group of 34 cases and the control group with 35 cases. All the patients were initially injected with 1 μg/kg of Fentanyl before preoperative anesthesia. The control group was treated with rou-tine anesthesia methods. The observation group was anaesthetized with dexmedetomidine. The mean arterial blood pressure （MAP）, PaO2, PaCO2 in the patients in operating room （T1）, propofol and dexmedetomidine （T2）, after placement of head frame （T3）, after drilling （T4）, were recorded. The adverse reactions of the two groups were com-pared. Results：In the observation group, the heart rate in the T 3 and T4 time group was significantly decreased com-pared with the control group whereas the PaO2 in the T3 and T4 time group was significantly increased compared with the control group （ 〈0.05）. Compared with the control group, the MAP, PaCO 2 in T4 time of the observation group showed significant changes （ 〈0.05）. The hypotension, tachycardia, impetuous people, postoperative vomit-ing numbers in the observation group changed significantly compared with the control group（ 〈0.05）. Conclusion：Compared with propofol, dexmedetomidine showed a better effect on anesthesia for the treatment of cerebral hem-orrhageusing stereotactically minimal invasive suction of intracranial hematomas. The patients showed more stable MAP, heart rate, PaO2 wave, and less respiratory depression.