单次剂量右美托咪定对脊柱侧凸矫形术中唤醒试验的影响  

Effects of single dose of dexmedetomidine on intraoperative wake-up test in patients undergoing scoliosis surgery

作　　者：刘卫锋[1] 窦云凌[1] 李梅娜[1] 邓耀龙 杨军林 舒海华[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广州市510080 [2]脊柱外科

出　　处：《实用医学杂志》2013年第15期2433-2435,共3页The Journal of Practical Medicine

摘　　要：目的：评价单次剂量右关托咪定对脊柱侧凸矫形术中唤醒试验的影响。方法：ASA Ⅰ-Ⅱ级特发性脊柱侧凸矫形术患者50例，随机分为D组和C组，每组25例。2组均采用丙泊酚靶控和瑞芬太尼恒速输注的全凭静脉麻醉，D组诱导插管后给予右美托咪定1μg／kg静脉输注,C组输注生理盐水。记录唤醒时间并评价唤醒质量；记录麻醉前（T0）、术中唤醒停药时（T1）、唤醒时（T2）、唤醒后10min（T3）和术毕拔管（T4）各时间点MAP和HR；记录手术开始至唤醒试验的时间、麻醉时间、手术时间、苏醒时间和术中知晓情况。结果：2组患者唤醒时间和苏醒时间差异无统计学意义（P〉0．05）。D组唤醒质量优于C组（P〈0．01）。T2和T3时间点D组患者MAP和HR低于C组（P〈0．05），其余时间点比较差异无统计学意义（P〉0．05）。均未发生术中知晓。结论：单次剂量右美托咪定可提高脊柱侧凸矫形术中唤醒试验质量，血流动力学平稳，不受反应少。Objective To observe the effects of single dose of dexmedetomidine on intraoperative wake- up test in patients undergoing scoliosis surgery. Methods Fifty patients scheduled for posterior scoliosis correction （ASA I -II, aged 12 - 28 years） were randomly divided into 2 groups （each n = 25）. Target controlled infusion of propofol and constant infusion of remifentanil were used to maintain the anesthesia in both groups. Patients in group D were given intravenous injection of dexmedetomidine （1 μg/kg） within 30 minutes after intubation; while those in group C were infused with an equal volume of normal saline. Awakening time from anesthesia was recorded and arousal quality was also evaluated. Mean arterial pressure （MAP） and heart rate （HR） were recorded at the following time points： before anesthesia （TO）, when anesthetics was stopped （T1）, when wake-up test was undergoing （T2）, 10 minutes after wake-up test （T3） and after extubation （T4）. The time from incision to wake-up test, whole anesthesia and operation time, awakening time, and the awareness occurrence were also recorded. Results There were no significant differences in awakening time and awakening time from anesthesia between the two groups （P 〉 0.05）. The wake-up test quality in group D was improved as compared with that in group C （P 〈 0.01）. MAP and HR in group D were significantly lower than those in group C at T2 and T3 （P 〈 0.05）. Neither group had awareness occurrence during the operation. Conclusion Single dose of dexmedetomidine could improve the wake-up test quality, maintain hemodynamic stability during scoliosis surgery.

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]