右旋美托咪啶对腹部手术患者全麻苏醒的影响  

Influence of Dexmedetomidine on recovery profiles from general anesthetic in patients undergoing abdominal surgery

作　　者：刘家欣[1] 黄贤君[1] 李晓鹏[2] 刘克玄[1] 李偲[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广州510080 [2]中山大学附属第一医院康复科,广州510080

出　　处：《中华普通外科学文献（电子版）》2012年第5期37-39,42,共4页Chinese Archives of General Surgery(Electronic Edition)

基　　金：广东省自然科学基金(S2011010004794);广东省卫生厅基金(B201080)

摘　　要：目的观察右旋美托咪啶分别复合七氟醚及丙泊酚对全麻患者苏醒的影响。方法选择全麻下行腹部手术患者80例,随机双盲分为4组:七氟醚+生理盐水组(S组)、丙泊酚+生理盐水组(P组)、七氟醚+右旋美托咪啶组(SD组)及丙泊酚+右旋美托咪啶组(PD组)。右旋美托咪啶用生理盐水稀释成4μg/ml,诱导插管后以3μg·kg-1·h-1静脉泵注10min,再以0.3μg·kg-1·h-1恒速维持至手术结束。S组及P组则于诱导插管后按相同速度静脉泵注生理盐水至手术结束。术中调节各组七氟醚和丙泊酚用量,以维持BIS在45±5。术后记录患者停药至睁眼的时间,并用短期定向记忆实验测量患者的认知功能。结果术后苏醒期,S组、P组和SD组的睁眼时间组间无统计学差异,但PD组患者睁眼时间较其他3组显著延长(P<0.05)。术前及术后60min,4组患者MMSE评分差异无统计学意义。结论右旋美托咪啶不会影响患者术后的认知功能恢复,但它会延长静脉麻醉患者的苏醒时间。Objective To observe the effect of co -administration of dexmedetomidine on the recovery profiles from general anesthetic. Methods Eighty patients undergoing abdominal surgery were randomly divided into four groups： sevoflurane and saline （group S）, propofol and saline （group P）, both sevoflurane and dexmedetomidine（group SD）, or propofol and dexmedetomidine （group PD） as maintenance general anesthetics. After induction, saline and dexmedetomidine were pumped at the rate of 3 μg·kg -1 ·h -1 for 10min and maintained at 0.3 μg·kg -1 ·h -1 by the end of the surgery. Bispectral Index values were maintained within 45 ±5 by changing the concentration of sevoflurane or the infusion rate of propofol in all groups. After operation, the time between the interruption of maintenance general anesthetics and eye opening was measured. Postoperative cognitive function was evaluated using the Short Orientation Memory Concentration Test. Results The time to eye opening of groups S, P and SD was comparable. The time to eye opening of group PD was significantly longer than those of the other three groups （ P 0.05）. The scores of MMSE between the four groups were similar and were not bechanged by co -administration of dexmedetomidine. Conclusions Postoperative cognitive function will not affected by dexmedetomidine administration. Dexmedetomidine may delay recovery when given as an adjuvant to propofol during total intravenous anesthesia.

关 键 词：右旋美托咪啶 七氟醚 丙泊酚 腹部手术 

分 类 号：R614[医药卫生—麻醉学]