小剂量右美托咪定在高血压脑出血患者开颅手术中的麻醉效果分析

Analysis of anesthetic effect of low-dose dexmedetomidine in craniotomy for patients with hypertensive cerebral hemorrhage

目的 分析小剂量右美托咪定在高血压脑出血患者开颅手术中的麻醉效果。方法 108例高血压脑出血患者,依据电脑随机筛选分为观察组与对照组,各54例。对照组在诱导麻醉前注射丙泊酚,观察组在诱导麻醉前泵注小剂量右美托咪定,并静脉注射右美托咪定直至手术后。比较两组不良事件发生情况及不同时间点[入室时(T0)、泵注右美托咪啶或生理盐水后(T1)、插管后(T2)、切头皮时(T3)、恢复自主呼吸时(T4)]心率(HR)、平均动脉压(MAP)水平。结果 T1、T2、T3、T4时,观察组HR分别为(86.57±9.24)、(85.62±8.88)、(85.16±9.69)、(84.35±9.26)次/min,均优于对照组的(102.21±10.36)、(98.29±10.37)、(98.36±10.08)、(97.23±11.33)次/min;观察组MAP分别为(88.52±11.26)、(87.79±10.31)、(87.26±11.26)、(86.42±10.18)mm Hg(1 mm Hg=0.133 kPa),均优于对照组的(110.36±10.69)、(108.42±10.59)、(105.58±10.03)、(102.23±10.26)mm Hg,差异有统计学意义(P<0.05)。观察组不良事件发生率为3.70%明显低于对照组的16.67%,差异有统计学意义(P<0.05)。结论 在高血压脑出血患者的开颅手术中,应用小剂量右美托咪定能稳定患者的HR与MAP水平,降低不良事件发生率,具有更高的临床使用价值,应予以积极推广。

Objective To analyze the anesthetic effect of low-dose dexmedetomidine in craniotomy for patients with hypertensive cerebral hemorrhage.Methods A total of 108 patients with hypertensive intracerebral hemorrhage were randomly divided into observation group and control group,with 54 cases in each group.The control group was injected with propofol before induction of anesthesia,and the observation group was injected with low-dose dexmedetomidine before induction of anesthesia,and intravenously injected with dexmedetomidine until after the end of the surgery.Both groups were compared in terms of occurrence of adverse events and heart rate(HR),mean arterial pressure(MAP)levels at different time points[when entering the room(T0),after pumping dexmedetomidine or normal saline(T1),after intubation(T2),when cutting the scalp(T3),when resuming spontaneous breathing(T4)].Results At T1,T2,T3,and T4,the HR of the observation group were(86.57±9.24),(85.62±8.88),(85.16±9.69),and(84.35±9.26)beats/min,which were all better than(102.21±10.36),(98.29±10.37),(98.36±10.08),and(97.23±11.33)beats/min of the control group;the MAP of the observation group were(88.52±11.26),(87.79±10.31),(87.26±11.26),(86.42±10.18)mm Hg(1 mm Hg=0.133 kPa),which were all better than(110.36±10.69),(108.42±10.59),(105.58±10.03),and(102.23±10.26)mm Hg of the control group;all the differences were statistically significant(P<0.05).The incidence of adverse events in the observation group was 3.70%,which was significantly lower than 16.67%in the control group,and the difference was statistically significant(P<0.05).Conclusion In the craniotomy of patients with hypertensive cerebral hemorrhage,low-dose dexmedetomidine can stabilize the HR and MAP level of patients and reduce the incidence of adverse events,which has higher clinical value and should be actively promoted.