右旋美托咪定用于脊柱侧弯术中唤醒试验的观察  

Clinical Observation of Dexmedetomidine in Wake-Up Test in Scoliosis Surgery

作　　者：祁富军[1] 张旭东[1] 刘盼盼[1] 刘九虎[1] 霍建臻[1] 任鹏程[1] 

机构地区：[1]第四军医大学唐都医院全军骨肿瘤研究所麻醉科,陕西省西安市710038

出　　处：《中华全科医学》2012年第6期851-852,共2页Chinese Journal of General Practice

摘　　要：目的比较在青少年脊柱侧弯手术中,右旋美托咪定复合瑞芬太尼的全凭静脉麻醉与七氟烷复合芬太尼的静吸复合麻醉的唤醒试验时间及苏醒质量。方法 40例择期行脊柱侧弯矫正术的10～25岁患者,随机分入全凭静脉麻醉组(右美托咪定+瑞芬太尼+阿曲库铵,A组)和静吸复合麻醉组(七氟烷+芬太尼+阿曲库铵,B组)。于相应时点记录两组患者术中唤醒时间、唤醒质量,心率(HR)、平均动脉压(MAP)变化、术后苏醒时间、拔管时间以及术中唤醒时患者的躁动和术中知晓情况。结果 A组患者的术中唤醒时间较B组缩短,两组比较差异有统计学意义(P<0.05),A组患者的手术结束后睁眼时间和拔管时间较B组缩短(P<0.05),B组患者术中唤醒时HR、MAP明显高于A组(P<0.05),B组患者术中唤醒时出现躁动的例数增多(P<0.05),两组患者术中知晓情况差异无统计学意义。结论右旋美托咪定和瑞芬太尼复合的全凭静脉麻醉方案可以使患者在术中更快实施苏醒,且唤醒期间血流动力学稳定,躁动发生较少,不良事件发生率低,更安全可靠。Objective To compare anesthesia awake test time and quality between total intravenous anaesthesia with dexmedetomidine and remifentanil and inhalation-intravenous general anesthesia with seveofluorine and fentanyl in adolescent scoliosis surgery.Methods Forty patients aged 10 to 25 years old selective scoliosis correction technique were randomly divided into total intravenous anaesthesia group（dexmedetomidine＋remifentanil＋atracurium,group A） and inhalation-intravenous group（seveofluorine＋fentanyl ＋atracurium,group B）.The intraoperative awaken time,wake up quality,heart rate（HR）,mean arterial pressure（MAP）,wake time after surgery,extubation time,and the restless and awareness in the intraoperative awaken at different time point were recorded and compared in both groups.Results The intraoperative wake time in group A was shorter than that in group B,the differences were statistically significant（P0.05）;the wake time and extubation time after the surgery in group A was shorter than that in group B（P0.05）;HR and MAP at intraoperative awaken in group B was significantly higher than that of group A（P0.05）;there were more cases were with restless at intraoperative awaken in group B as compared to group A（P0.05）;the difference in intraoperative awareness was statistically significant between the two groups.Conclusion Total intravenous anaesthesia with dexmedetomidine and remifentanil can shorten the wake time,keep the the stability of bloodstream dynamics,decrease the rate of restless and adverse events.

关 键 词：右美托咪定 瑞芬太尼 全凭静脉麻醉 术中唤醒 

分 类 号：R682.3[医药卫生—骨科学]