对比不同剂量右美托咪啶对全麻颈椎前路手术老年患者的应用效果

Objective to compare the effects of different doses of dexmedetomidine on elderly patients undergoing anterior cervical spine surgery under general anesthesia

目的对比不同剂量的右美托咪啶对全麻颈椎前路手术的老年患者的临床疗效。方法选取2015年2月～2017年3月在温州医科大学附属第二医院进行全麻颈椎前路手术的老年患者40例，随机均分为对照组与观察组，每组20例。为对照组患者应用0.8μg/kg剂量右美托咪啶，观察组应用0.6μg/kg剂量右美托咪啶，然后对2组患者的血流动力学、体感诱发电位（SEPs）、运动诱发电位（MEPs）的变化情况进行比较。结果将其和T0时进行比较，2组患者的心率（HR）、平均动脉压（MAP）、脑电双频指数（BIS）都明显的下降（P＜0.05）；观察组患者的HR、MAP、BIS的检测值比较高。而对2组患者的SEPs的波幅以及其潜伏期等进行比较，结果显示差异无统计学意义，与对照组患者进行比较，观察组患者的SEPs的波幅以及潜伏期都明显的下降；对所有患者的SEPs、MEPs的监测成功率以及术中的知晓率等进行比较，结果显示差异无统计学意义。结论对于实施全麻颈椎前路手术的老年患者采用右美托咪啶静脉输注,将其使用剂量控制在0.6μg/kg左右，会对患者的血流动力学、SEPs、MEPs产生较小的影响，临床疗效比较显著。

Objective To compare the clinical effects of different doses of dexmedetomidine on general anesthesia in elderly patients with anterior cervical spine surgery.Methods40elderly patients with anterior cervical surgery from February2015to March2017in the Second Affiliated Hospital of Wenzhou Medical University were randomly divided into control group and observation group,the control group were treated with0.8μg/kg the dose of dexmedetomidine,the observation group used0.6μg/kg doses of dexmedetomidine,and compared the hemodynamics,the changes of somatosensory evoked potentials(SEPs)and motor evoked potentials(MEPs)in two groups of patients.Results The heart rate(HR),mean arterial pressure(MAP),brain bispectral index(BIS)decreased significantly(P<0.05)compared with that of post-treatment;the observation group of patients with HR,MAP,BIS detection value is relatively high.And the two groups of SEPs amplitude and the latency were compared,results showed that the difference was not statistically significant,and control groups were compared,the SEPs amplitude and latency of observation group are obvious decreased;the success rate of monitoring of SEPs,MEPs,and intraoperative awareness were compared for all patients,the results showed that the difference was not statistically significant.Conclusion It is less effect for SEPs,hemodynamics,and MEPs for patients,the dose control in0.6μg/kg for elderly patients with cervical anterior surgery under general anesthesia with dexmedetomidine intravenous infusion has significant clinical curative effect.