右美托咪定对颅内动脉瘤夹闭术患者苏醒期的影响

Effects of Dexmedetomidine on patients with intracranial aneurysms clipped during resuscitation period

目的探讨右美托咪定对颅内动脉瘤夹闭术患者苏醒期质量的影响。方法选择择期行颅内动脉瘤夹闭术患者30例,年龄18～65岁,ASA分级Ⅰ-Ⅱ级。将所有患者随机分为两组:生理盐水组(N组)和右美托咪定组(D组)。观察并比较两组患者麻醉苏醒期血流动力学数值和镇静-躁动评分在麻醉诱导前(T0),拔管即刻(T1),拔管后30min(T2)的变化。结果两组患者术前一般情况比较,差异无统计学意义(P>0.05);与T0相比,N组平均动血压(MAP)、心率(HR)、心指数(CI)在T1～2各时间点明显升高(P<0.05), D组变化不明显;与N组比较,D组在T1时间点MAP、 HR、CI明显降低(P<0.05);镇静-躁动评分D组显著低于N组(P<0.05)。结论术中持续静脉输注右美托咪定,不仅有利于维持颅内动脉瘤夹闭术患者苏醒期血流动力学的平稳,而且有效预防其术后躁动的发生,进而提高苏醒质量。

Objective To observe the effects of Dexmedetomidine on patients with surgical clipping of cerebral aneurysm during resuscitation period.Methods 30 cases of patients with surgical clipping of cerebral aneurysm were selected and the age ranged from 18-65 years,ASAI-II.Patients were randomly divided into 2 groups:Dexmedetoidine(Group D)and normal saline(Group N).Observation the records of patients at MAP、HR、CI,at the time of before anesthesia(T0),at extubation(T1)and after extubation 30 min(T2)and RSAS score.Results There was no significant difference in age,weight in two groups(P>0.05);Compare with T0,in group N,MAP、HR at T1-2 increased(P<0.05),but in group D,there was no significant difference;compared with group N,at T1 in group D,MAP、HR、CI significantly decreased(P<0.05);Compare with group N,RASA score in group D was significantly lower(P<0.05).Conclusion It is good for patients with surgical clipping of cerebral aneurysm by intravenous Dexmetomidine to maintain stable hemodynamic and prevent postoperative agitation and improve recovery quality.