不同镇静药物对老年蛛网膜下隙阻滞麻醉患者脑氧饱和度的影响

Effects of Midazolam and Dexmedetomidine on Regional Cerebral Oxygen Saturation in Elderly Patients with Spinal Anesthesia

目的:探讨咪唑安定和右美托咪定应用于老年蛛网膜下隙阻滞麻醉患者对其脑氧饱和度(rSO2)的影响。方法:根据入组标准,选择择期在蛛网膜下隙阻滞麻醉下行骨科手术的老年患者40例,随机分成2组,咪唑安定组(M组)和右美托咪定组(Y组),各20例。分别记录麻醉后(T0),给药后5 min (T1)、15 min (T2)、30 min (T3)、60 min (T4)和术毕(T5)各个时间点血流动力学指标包括心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2)、rSO2以及改良警觉/镇静评分(OAA/S)。结果:2组患者在给药后各时间点(T0除外) MAP、HR、OAA/S都较基础值显著下降,差异有统计学意义(P<0.05);2组患者不同时间点HR比较,差异有统计学意义(P<0.05)。2组患者各个时间点(T0除外)rSO2与同组麻醉后基础值相比都显著下降,差异有统计学意义(P<0.05)。2组患者组间比较,Y组各时间点(T0除外)的rSO2值均高于M组,差异有统计学意义(P<0.05)。结论:对于老年蛛网膜下隙阻滞麻醉患者,术中辅助镇静药物,右美托咪定比咪唑安定对rSO2的影响小。

Objective： To compare the effects of midazolam and dexmedetomidine on regional cerebral oxygen saturation （rSO2） in elderly patients with spinal anesthesia. Methods：According to the inclusion criteria, 40 patients underwent orthopedic stagery under spinal anesthesia were randomly divided into 2 groups （n=20） , midazolam group （group M） and dexmedetomidine group （group Y）. Heart rate （HR）, mean arterial pressure （MAP）, blood oxygen saturation （SpO2）, rSO2 and OAA/S score were recorded after anesthesia （TO, baseline）, at 5 （T1）, 15 （T2）, 30 （T3）, 60 （T4）min after administration of drugs and the end of operation （T5）. Results： Compared with the basline values （T0）, MAP, HR, rSO2 and OAA/S all significantly decreased at T1, T2, T3, T4 and T5 in the two groups （P〈0.05）. The rSO2 levels in group Y at T1, T2, T3, T4 and T5 were significantly higher than those in group M （P〈0.05）. Conclusion： For elderly patients with spinal anesthesia, dexmedetomidine has less influence on rSO2 than midazolam.