右美托嘧啶持续输注用于老年脊柱手术麻醉中的临床观察  

Efficacy of Continuous Infusion of Dexmedetomidine for Aged Patients During Spine Sugery

作　　者：苏小军[1] 李平[1] 郭正刚[1] 侯轶楠[1] 

机构地区：[1]解放军总医院第一附属医院麻醉科,北京100048

出　　处：《医学研究杂志》2014年第4期108-111,共4页Journal of Medical Research

摘　　要：目的 探讨右美托嘧啶持续输注对老年患者麻醉中血流动力学、麻醉药物用量及术后苏醒的影响.方法 50例择期老年脊柱手术患者按随机数字表法随机分为右美托嘧啶组（D组）和对照组（C组）,每组各25例.麻醉诱导前D组患者10min内静脉泵入0.5μg/kg右美托嘧啶,C组泵入等量生理盐水.然后行麻醉诱导气管内插管,同时以0.4μg/（kg·h）速度持续泵注右美托嘧啶至手术结束.术中以丙泊酚和瑞芬太尼持续输注维持麻醉,维持术中脑电双频谱指数（BIS）为40 ～60.记录患者血流动力学变化,手术时间,麻醉药物用量及苏醒时间.结果 输注右美托嘧啶5min时,D组平均动脉压较C组升高;8min及10min时心率、平均动脉压及BIS值较C组降低.插管时两组血压、心率均有升高,但C组血压、心率升高较D组有统计学差异.两组手术时间、术中血压、心率变化无统计学差异,拔管时C组血压、心率升高较D组有统计学差异.术中丙泊酚及瑞芬太尼用量D组明显少于C组.苏醒期D组BIS值恢复至60、70、80及睁眼时间较C组明显延长.结论 右美托嘧啶持续输注用于老年患者脊柱手术的麻醉,有利于维护老年患者血流动力学的稳定,减少丙泊酚和瑞芬太尼的用量,但延长患者术后苏醒时间.Objective To evaluate the perioperative effect of intraoperative infusion of dexmedetomidine in aged patients undergoing spine surgery under total intravenous anesthesia.Methods Fifty patients （aged 65-85years） scheduled for elective spine surgery were randomly allocated to dexmedetomidine group （group D,n =25 per group） or control group （group C）.Placebo or dexmedetomide 0.5μg/kg was given as a bolus dose 10 minutes before induction,followed by a maintenance infusion of 0.4μg/（kg · h） until the end of surgery.Propofol and remifentanil were pumped intravenously to maintain the Bispectral index （BIS） 40-60.Haemodynamic changes,time of surgery,anesthetic requirements and recovery time were recorded.Results During the bolus dose infused time,compared to group C,MAP incraesed in group D at 5 minutes,however MAP,HR and BIS value decreased at 8 or 10 minutes.Though MAP and HR increased in the two groups at the time of intubation and extubation,group C got a higher MAP and HR compared to group D.The operation time,MAP and HR during the operation had no significant difference.Group D required less propofol and remifentanil throughout the operation.The time to eye opening of group D was much longer than that of group C.Conclusion Continuous infusion of dexmedetomidine for aged patients maintains the haemodynamic stability,reduces the anesthetics requirement and prolongs the recovery time.

关 键 词：右美托嘧啶 老年 全凭静脉麻醉 

分 类 号：R614[医药卫生—麻醉学]