自然睡眠与右美托咪定镇静期间心率相关性分析

Correlation analysis of the heart rate between natural sleep and during dexmedetomidine sedation

目的评估自然睡眠和右美托咪定镇静期间心率变化的关系。方法选择2021年1月至2022年6月30例在脊柱麻醉下进行择期手术患者。采用脉搏血氧仪和脑电双频指数(BIS)监护仪,在基线测量心率和BIS后;当患者睡眠时,BIS低于70时,在睡眠期间每隔5 min测量心率和BIS。在脊髓麻醉前,记录基线心率和BIS,在注射右美托咪定后每隔5 min测量心率和BIS。采用回归分析评估自然睡眠与右美托咪定镇静之间心率变化的关系。结果自然睡眠和右美托咪定镇静之间基线心率差异有统计学意义[(72±7)次/min和(80±8)次/min,P<0.001]。自然睡眠时达到最低点的时间为(66.4±7.0)min,右旋美托咪定镇静时达到最低点时间为(12.6±1.3)min,两者差异有统计学意义(P<0.001),但获得的最低心率差异无统计学意义。自然睡眠和右美托咪定镇静之间心率降低显著相关(r=0.42,P<0.001)。结论自然睡眠和右美托咪定镇静之间心率降低存在相关性。使用右美托咪定时出现心动过缓可能是一种正常的生理变化。

Objective To investigate the changes in heart rate between during natural sleep and dexmedetomidine sedation.Methods Thirty patients undergoing elective surgery under spinal anesthesia were studied.Pulse oximetry and bispectral index(BIS)monitors were used to measure the heart rate and BIS at baseline and at 5 min intervals during sleep when BIS was below 70.Baseline heart rate and BIS were recorded before spinal anesthesia and measured at 5 min intervals after dexmedetomidine injection.Regression analysis was performed to assess heart rate changes between natural sleep and dexmedetomidine sedation.Results There was significant difference in baseline heart rate between natural sleep and dexmedetomidine sedation[(72±7)beats/min vs(80±8)beats/min,P<0.001].The time to reach the lowest point during natural sleep was(66.4±7.0)min,while the time to reach the lowest point during dexmedetomidine sedation was(12.6±1.3)min,there was a statistical difference(P<0.001),but there was no difference in the minimum heart rate.There was significant correlation between natural sleep and decreased heart rate(r=0.42,P<0.001).Conclusion There was a correlation between the change in heart rate during natural sleep and dexmedetomidine sedation.The bradycardia that occurs when using dexmedetomidine may be a normal physiologic change.