右美托咪定对全麻下脑语言功能区手术术中唤醒的影响  

The effect of dexmedetomidine on the wake-up in the language areas brain surgery

作　　者：高鹏[1] 古妙宁[2] 蔡铁良[1] 沈七襄[1] 张正迪[1] 施琼[1] 

机构地区：[1]解放军第174医院麻醉科,厦门市361003 [2]广州南方医科大学附属南方医院麻醉科

出　　处：《临床麻醉学杂志》2015年第1期60-62,共3页Journal of Clinical Anesthesiology

基　　金：南京军区医药卫生科研基金课题(编号NO.072017)资助

摘　　要：目的研究右美托咪定对全麻下脑语言功能区手术术中唤醒的影响。方法选择ASAⅠ或Ⅱ级累及脑语言区并排除严重心肺疾病患者20例,于全麻下行开颅手术,术中唤醒前停用全麻用药,并以右美托咪定0.1～0.2μg·kg^-1·h^-1和瑞芬太尼0.05μg·kg^-1·min^-1维持,保持患者清醒至唤醒结束。观察并记录停药至清醒时间、唤醒时间、清醒时间,记录清醒程度和带管讲话状态评分,观察恶心、呕吐、躁动不良反应发生情况及术后不良记忆。结果患者麻醉时间（563±48）min,手术时间（454±36）min,唤醒时间（58±21）min,停药至清醒时间（12±2）min,清醒时间（32±8）min。清醒期MAP明显升高、HR明显增快,PaO2明显降低,PaCO2明显升高（P〈0.05）。患者清醒程度和带管讲话状态评分为优。无一例患者术后发生恶心、呕吐、躁动不良反应和不良记忆。结论右美托咪定用于全麻下脑语言功能区手术的术中唤醒具有易调控、易唤醒、患者易配合、对循环、呼吸干扰轻微的优势。Objective This study is to observe the effect of dexmedetomidine on brain language function areas in patients undergoing wake-up brain surgery.Methods Twenty patients with ASA ⅠorⅡ without no serious heart and lung disease,undergoing surgery on the brain language function area were enrolled.Before the wake-up procedure,the anesthesia drugs was stopped,and intravenous Dexmedetomidine 0.1-0.2μg·kg^-1·h^-1 and remifentanyl 0.05μg·kg^-1·min^-1 were continuously infused during the wake-up procedure.The awake time and the BP,HR,intracranial pressure,the clarity of the speech,the effects of complete instructions and adverse reaction were observed.Results The durationof anesthesia was（563±48）min,duration of surgery was（454±36）min,awake time was（58±21）min,time from stopped drug infusing to awaken was（12±2）min and recovery time was（32±8）min.BP was increased,HR was faster during recovery.PaO2 was decreased significantly,PaCO2 was increased significantly（P〈0.05）.The degree of awakening and speech with intubation were good.No patient had nausea,vomiting,restlessness and harmful memory.Conclusion Dexmedetomidine is good to be used for the surgery of brain language function area with the advantage of easy control,patientsgood cooperation,and no circulatory or respiratory disturbance.

关 键 词：右美托咪定 脑功能区手术 术中唤醒 

分 类 号：R614[医药卫生—麻醉学]