右美托咪定对脑功能区手术术中唤醒麻醉后患者神经功能及SOD、MDA水平的影响

Effects of Dexmedetomidine on Neurological Function and Levels of SOD and MDA in Patients Undergoing Surgery in Brain Functional Area under Intraoperative Awakening Anesthesia

目的探讨右美托咪定用于脑功能区手术术中唤醒麻醉对患者神经功能及超氧化物歧化酶(SOD)、丙二醛(MDA)水平的影响。方法选择2019年5月-2021年5月我院收治的择期行脑功能区手术患者60例,按麻醉方法分为观察组和对照组,每组30例。2组均给予常规麻醉,观察组在此基础上给予右美托咪定,对照组给予芬太尼。比较2组术中唤醒前麻醉用药量、唤醒时间、唤醒前麻醉时间及不良反应发生情况;观察2组手术前后神经受损情况;比较2组手术前后血清学指标水平。结果观察组唤醒时间短于对照组,唤醒前丙泊酚、瑞芬太尼用药量少于对照组(P<0.05)。2组术后神经功能缺损量表评分高于术前,观察组低于对照组(P<0.05)。2组术后中枢神经系统特异性蛋白质(S100β)、MDA水平低于术前,SOD水平高于术前(P<0.05)。观察组术后S100β、MDA水平低于对照组,SOD水平高于对照组(P<0.05)。观察组不良反应总发生率低于对照组(P<0.05)。结论在常规麻醉基础上予以右美托咪定可缩短术中唤醒麻醉下脑功能区手术患者唤醒时间,减少部分麻醉用药量,减轻术后脑功能区神经功能障碍,并降低术后MDA水平、升高SOD水平。

Objective To investigate effects of Dexmedetomidine on neurological function and levels of superoxide dismutase(SOD)and malondialdehyde(MDA)in patients undergoing surgery in brain functional area under intraoperative awakening anesthesia.Methods A total of 60 patients with elective surgery in brain function area who were admitted between May 2019 and May 2021 were selected and divided into observation group and control group according to anesthesia methods(n=30 in each group).Both groups were given conventional anesthesia,and observation group was added with Dexmedetomidine,while control group was added with Fentanyl.The intraoperative awakening anesthesia dosage,wake-up time,anesthesia time before wake-up and incidence rates of adverse reactions were compared between two groups.Conditions of nerve damage before and after surgery were observed in two groups.Levels of serological indexes before and after surgery were compared between two groups.Results In observation group,wake-up time was shorter,and dosages of Propofol and Remifentanil before wake-up were less than those in control group(P<0.05).Postoperative neurological function deficit scale(NFDS)scores were higher than those before surgery in two groups,and the score in observation group was lower than that in control group(P<0.05).After surgery,levels of central nervous system-specific protein(S100β)and MDA were lower than those before operation,while SOD levels were higher than those before surgery in two groups(P<0.05).After operation compared with those in control group,levels of S100βand MDA were lower,while SOD level was higher in observation group(P<0.05).The total incidence rate of adverse reactions in observation group was lower than that in control group(P<0.05).Conclusion Dexmedetomidine on the basis of conventional anesthesia may shorten the wake-up time,reduce the partial dose of anesthesia,ameliorate postoperative neurological dysfunction in the brain function area,reduce postoperative MDA levels and increase SOD levels of patients undergoing surgery in brain function area under intraoperative awakening anesthesia.