右美托咪定对颅脑外科术后全麻苏醒期血流动力学和苏醒质量的影响

Effect of Dexmedetomidine to the Emodynamics and Revival Quality during the Revival Period of General Anesthesia in the Patients with Craniocerebral Operation

目的观察右美托咪定对颅脑外科手术全麻苏醒期血流动力学和苏醒质量的影响。方法 2014年1月～2014年12月在本院择期行颅脑外科手术患者56例随机分为观察组和对照组,手术结束前30min观察组患者采用微量泵注右美托咪啶0.5μg/kg,15min内输完,对照组患者采用微量泵注同体积的0.9%生理盐水。记录两组患者术后呼吸恢复时间、睁眼时间、拔管时间和定向力恢复时间;记录两组手术结束前30min（T1）、拔管时（T2）、拔管后3min（T3）、10min（T4）和30min（T5）病人的心率、平均动脉压和血氧饱和度;拔管期间躁动发生情况。结果 （1）两组患者的麻醉时间、手术时间和术中出血量差异均无统计学意义（P〉0.05）;（2）观察组T2、T3和T4时心率、平均动脉压和血氧饱和度与对照组患者比较差异具有统计学意义（P〈0.01）,T5时两组患者心率、平均动脉压和血氧饱和度均无统计学意义（P〉0.05）;（3）两组患者术后呼吸恢复时间、睁眼时间、拔管时间、定向力恢复时间差异均无统计学意义（P〉0.05）,但是躁动发生率差异有统计学意义（P〈0.05）。结论颅脑外科手术结束前静注右美托咪定可稳定全麻苏醒期血流动力学,有效减少全麻苏醒期躁动的发生,可提高颅脑外科手术术后全麻苏醒期的苏醒质量。

Objective To observe the effect of dexmedetomidine to the hemodynamics and revival quality during the revival period of general anesthesia in the patients with craniocerebral operation. Methods A total of56 patients with craniocerebral operation, who visited our hospital in January- December 2014 were randomly divided into Observation Group and Control Group. Cases in Observation Group received dexmedetomidine 0.5 μg/kg by micro pump, and cases in Control Group received 0.9% normal saline in the same volume. The time of breath recovery, opening eyes, tube drawing time and directive force in both groups were recorded. Heart rate, mean pulse pressure, and oxygen saturation were recorded at 30 th min before operation（T1）, extubation time（T2）, 3rd min（T3）, 10 th min（T4） and 30 th min（T5） after extubation Agitation occurrence were record in the period of extubation. Results（1） The anesthesia time, operation time and blood loss were not significantly different in both groups（P〉0.05）.（2） The Heart rate, mean pulse pressure, and oxygen saturation at T2, T3 and T4were significantly different in both groups（P〈0.01）, but they were not significantly different in both groups（P〉0.05）.（3） The time of breath recovery, opening eyes, tube drawing time and directive force in both group were not significantly different in both groups（P〉0.05）, and agitation occurrence were different in both groups（P〈0.05）. Conclusion Injecting dexmedetomidine before operation termination can stabilize the hemodynamics during recovery period of general anesthesia, and can reduce agitation occurrence, and can increase the revival quality during the revival period of general anesthesia.