盐酸右美托咪啶在七氟醚稳态吸入下对脑功能状态指数的影响  

Dexmedetomidine decreases cerebral state index under the steady-state anesthesia of sevoflurane

作　　者：钟桥生[1] 屈献锋[1] 王文勇[1] 杨礼[1] 王筱斐 杨小平[1] 

机构地区：[1]台州市立医院麻醉科,318000

出　　处：《浙江医学》2014年第19期1632-1634,共3页Zhejiang Medical Journal

基　　金：浙江省医学会临床科研基金项目(2012ZYC-A96)

摘　　要：目的：观察盐酸右美托咪啶在七氟醚稳态吸入下对脑功能状态指数（CSI）的影响。方法选取择期妇科腹腔镜手术的患者60例，采用随机数字表法分为盐酸右美托咪啶组（D组）和0.9%氯化钠溶液对照组（C组），各30例。七氟醚吸入诱导，气管插管后调整七氟醚呼气末浓度为1.0 MAC并维持15min后，D组盐酸右美托咪啶以负荷量0.4μg/kg微量泵静脉泵注10min，再以维持量0.4μg/（kg·h）静脉持续泵注；C组给予等量0.9%氯化钠溶液。记录静卧5min后（T0）、气管插管后（T1）、七氟醚达稳态（T2）、泵注5（T3）、10（T4）、15（T5）、20（T6）、25（T7）、30 min（T8）各时点的SBP、DBP、MBP、HR和CSI；记录麻醉期间低血压、高血压、心率增快和心率减慢的发生情况。结果 D组患者T4-T8时的SBP、DBP、MBP、HR和CSI显著低于C组和T2时，差异均有统计学意义（均P＜0.05）。两组患者低血压、高血压、心率增快和心率减慢发生率的差异均无统计学意义（均P＞0.05）。结论盐酸右美托咪啶能降低七氟醚稳态吸入下的CSI，同时产生降低血压和心率的作用。Objective To investigate the effects of dexmedetomidine on cerebral state index（CSI） under the steady- state anesthesia of sevoflurane. Methods Sixty patients scheduled for elective gynecologic laparoscopic operation were randomly divided into two groups with 30 in each. Al patients were induced with sevoflurane, the end- tidal concentrations of sevoflurane in two groups were adjusted to 1.0 MAC and maintained for 15 min after tracheal intubation. A load dose of 0.4μg/kg dexmedetomidine was injected for 10 min fol owed by infusion of 0.4μg/ （kg·h） until the end of trial in group D;same volume of 0.9%normal saline was given in group C. Systolic blood pressure （SBP）, diastolic blood pressure （DBP）, mean blood pressure （MBP）, heart rate （HR） and CSI were recorded at lying stil for 5 min（T0）, immediately after intubation（T1）, steady state of sevoflu-rane （T2）, infusion after 5, 10, 15, 20, 25 and 30 min （T3, T4, T5, T6, T7 and T8）. The incidence of hypotension, hypertension, tachy-cardia and bradyrhythmia were recorded. Results SBP, DBP, MBP, HR and CSI at T4-T8 were significantly lower in group D than those in group C and T2（P〈0.05） . No significant difference was found in incidence of hypotension, hypertension, tachycar-dia and bradyrhythmia between two groups （P〉0.05）. Conclusion Dexmedetomidine can reduce the CSI under the steady- state anesthesia of sevoflurane and lower blood pressure and heart rate at the same time.

关 键 词：盐酸右美托咪啶 七氟醚 稳态吸入 脑功能状态指数 

分 类 号：R614[医药卫生—麻醉学]