小剂量右美托咪啶在神经外科患者气管切开术中的应用  

Application of small dose of dexmedetomidine in neurosurgical patients undergoing tracheotomy

作　　者：王卡[1,2] 田国刚[1,2] 唐群新[1,2] 

机构地区：[1]海口市人民医院 [2]中南大学湘雅海口医院麻醉科,海南海口570208

出　　处：《海南医学》2013年第18期2681-2682,共2页Hainan Medical Journal

摘　　要：目的探讨小剂量右美托咪啶在神经外科患者气管切开术中的应用。方法神经外科拟行气管切开术患者40例,随机分为右美托咪啶组(D组)和生理盐水组(NS组)。入室后D组在10 min之内缓慢静脉注射右美托咪定0.5μg/kg,NS组则缓慢注射等量生理盐水。记录两组患者入室时(T0)、药物注射结束时(T1)、局麻时(T2)、手术切皮时(T3)以及术毕(T4)时的HR、MAP、RR、SpO2。记录术中体动、呛咳、呼吸抑制及心血管不良反应的发生情况。结果 NS组在T2、T3和T4的HR、MAP均明显高于T0时,D组上述时点的上述指标明显低于NS组(P<0.05);D组T1的HR、MAP均明显低于T0时(P<0.05)。术中高血压、心动过速、体动及呛咳的发生率D组明显低于NS组(P<0.05)。两组均未发生呼吸抑制。结论小剂量右美托咪啶能减少神经外科气管切开术中体动、呛咳的发生,稳定血流动力学且未见呼吸抑制,具有良好的临床应用。Objective To observe the application of small dose of dexmedetomidine in neurosurgical pa- tients undergoing traeheotomy. Methods Forty neurosurgical patients undergoing traeheotomy were randomly divid- ed into two groups. Twenty patients were administered dexmedetomidine 0.5 μg/kg over 10 minutes after opening the venous channel （group D）, and 20 patients were administered normal saline in the same volume （group NS）. Heart rate （HR）, mean arterial pressure （MAP）, respiratory rate （RR）, SpO2 were recorded after admission （T0）, the end of drug administration （T1）, after local anesthesia （T2）, after skin incision （T3） and the end of surgery （T4）. Intraoperative body movement, cough, cardiovascular adverse reactions and respiration depression were recorded. Results HR and MAP at T2, T3, T4 in group NS were significantly higher than at To, and those at T2, T3, T4 in group D were significantly lower than group NS. In group D, HR and MAP at T1 were significantly lower compared with at To （P〈0.05）. The incidence of hypertension, trachyeardia, body movement and cough were significantly decreased in group D. No respiration de- pression happened in all the patients. Conclusion Small dose of dexmedetomidine can be well used in neurosurgieal patients undergoing tracheotomy. It makes hemodynamics more stable and causes less body movement, cough, with no respiration depression.

关 键 词：右美托咪啶 气管切开术 神经外科 

分 类 号：R653[医药卫生—外科学]