不同剂量右美托咪定用于颅脑手术患者的效果观察

The effect of different doses of dexmedetomidine on patients undergoing craniocerebral surgery

目的研究不同剂量右美托咪定用于颅脑手术患者的临床价值,为优化颅脑手术的麻醉方案提供参考。方法选取2017年6月至2021年6月陕西省人民医院收治的90例颅脑手术患者为研究对象,按照随机数字表法分为A组、B组和C组,各30例。3组患者均在手术完成前15 min肌内注射右美托咪定,A组剂量为1.0μg/kg,B组为1.5μg/kg,C组为2.0μg/kg。记录3组患者术前(T_(1))、给药前5 min(T_(2))、手术结束时(T_(3))及术后30 min时(T_(4))血流动力学指标水平,记录3组患者麻醉不良反应发生率。结果A、C两组患者T_(1)、T_(2)、T_(3)及T_(4)时心率(HR)和平均动脉压(MAP)水平比较,差异均有统计学意义(均P<0.05)。B组患者各时间点HR、MAP及SpO2水平比较,差异无统计学意义(P>0.05)。3组患者心动过缓发生率比较,差异有统计学意义(P<0.05),其中B组患者心动过缓发生率显著低于C组(P<0.05)。结论右美托咪定用于颅脑手术患者麻醉效果可靠,手术结束前采用1.5μg/kg剂量的右美托咪定有助于稳定血流动力学,减轻术后不良反应,值得临床应用。

Objective To study the clinical value of different doses of dexmedetomidine in patients undergoing craniocerebral surgery,to provide reference for optimizing anesthesia plan of craniocerebral surgery.Methods 90 patients with craniocerebral surgery in Shaanxi Provincial People’s Hospital from June 2017 to June 2021 were collected as the research objects,and the 90 patients were randomly divided into group A,group B and group C(30 cases in each group).The dexmedetomidine was injected intramuscularly 15 minutes before the operation of the three groups.The dose of group A was 1.0μg/kg;the dose of group B was 1.5μg/kg;the dose of group C was 2.0μg/kg.The hemodynamic indexes were recorded before operation(T_(1)),5 minutes before administration(T_(2)),at the end of operation(T_(3))and 30 minutes after operation(T_(4)).The incidence of anesthesia related adverse reactions before and after operation were recorded.Results There were significant differences in heart rate(HR)and the mean arterial pressure(MAP)at T_(1),T_(2),T_(3) and T_(4) in either A group or C group(P<0.05).There were no significant difference in HR,MAP and SpO2 levels at each time point in group B(P>0.05).There was significant difference in the incidence of bradycardia among the three groups(P<0.05),the incidence of bradycardia in group B was significantly lower than that in group C(P<0.05).Conclusion The dexmedetomidine has reliable anesthetic effect in patients underwent craniocerebral surgery.It is helpful to stabilize hemodynamics and reduce postoperative adverse reactions by 1.5μg/kg of dexmedetomidine 15 minutes before the end of the operation.It is worthy of clinical application.