右美托咪定对脊柱侧弯矫形术患者术中唤醒试验的影响  

Effect of dexmedetomidine on intraoperative wake-up test in patients undergoing scoliosis surgery

作　　者：张承华[1] 麻伟青[1] 杨云丽[1] 王慧明[1] 董发团[1] 奚曦[1] 刘洁[1] 

机构地区：[1]成都军区昆明总医院麻醉科,650032

出　　处：《中华麻醉学杂志》2012年第10期1173-1175,共3页Chinese Journal of Anesthesiology

基　　金：云南省卫生厅基金（2011FZ317）

摘　　要：目的评价右美托咪定对脊柱侧弯矫形术患者术中唤醒试验的影响。方法选择拟行脊柱侧弯矫形术患者60例，年龄13～18岁，ASA分级I级。采用随机数字表法，将患者随机分为2组（n=30）：舒芬太尼组（s组）和右美托咪定＋舒芬太尼组（Ds组）。两组均采用舒芬太尼、依托咪酯、顺阿曲库铵麻醉诱导，气管插管后机械通气，靶控吸入七氟醚复合靶控输注舒芬太尼维持麻醉。DS组麻醉诱导后静脉输注右美托咪定0．2gg·kg-1·h-1至术毕，s组以等容量生理盐水替代。唤醒试验前停止输注顺阿曲库铵，下调七氟醚呼气末靶浓度至0；S组、Ds组分别下调舒芬太尼ce至0．1、O．08ng／ml。5mn后开始唤醒试验。记录唤醒时间、唤醒期间呛咳／躁动和心血管事件的发生情况。术后随访患者，记录术中知晓的发生情况。结果Ds组唤醒时无心血管事件发生。与s组比较，Ds组唤醒时间缩短，心血管事件、呛咳，躁动的发生率降低（P〈0．05）。术后随访无一例发生术中知晓。结论右美托咪定可用于脊柱侧弯矫形术患者术中唤醒试验，唤醒时间短，血液动力学平稳，不良反应少。Objective To evaluate the effect of dexmedetomidine on intraoperative wake-up test in patients undergoing scoliosis surgery. Methods Sixty ASA I patients, aged 13-18 yr, scheduled for elective scoliosis surgery, were randomly divided into 2 groups （ n = 30 each） ： sufentanil group （group S） and dexmedetomidine combined with sufentanil group （group DS）. Anesthesia was induced with sufentanil, etomidate and cisatracurium, and maintained with target-controlled inhalation of sevoflurane combined with target-controlled infusion of sufentanil in both groups. In group DS, dexmedetomidine 0.2 μg. kg-l . h-1 was infused during operation, while the equal volume of normal saline was given instead in group S. Before the wake-up test, cisatracurium infusion was stopped, the end-tidal concentration of sevoflurane was adjusted to 0, and the target effect-site concentration of sufentanil was adjusted to 0.1 and 0.08 ng/ml in groups S and DS,respeetively. The wake-up test was performed 5 min later. The wake-up time and bucking/restlessness and cardiovascular events during the wake-up test were recorded. The occurrence of intraoperative awareness was recorded in the patients who were followed up after operation. Results No cardiovascular events occurred during the wake-up test in group DS. The wake-up time was signifieandy shorter and the incidences of cardiovascular events and bucking/restlessness were significantly lower in group DS than in group S （ P 〈 0.05）. No intraoperative awareness occurred in the patients. Conclusion Dexmedetomidine can be used for intraoperative wake-up test in patients undergoing scoliosis surgery, with shorter wakeup time, stable hemodymamics and fewer adverse reactions.

关 键 词：右美托咪啶 脊柱侧凸 唤醒试验 

分 类 号：R614[医药卫生—麻醉学]