Narcotrend监测下右美托咪啶在语言功能区手术中唤醒麻醉的临床研究  

Clinical analysis of dexmedetomidine in intraoperative wake- up test during language functional surgery with narcotrend monitor

作　　者：钟宝琳[1] 黄桂明[1] 李以平[1] 陈以建[1] 李优春[1] 

机构地区：[1]赣州市人民医院麻醉科,江西赣州341000

出　　处：《中国临床药理学杂志》2015年第19期1916-1918,共3页The Chinese Journal of Clinical Pharmacology

基　　金：赣州市指导性科技计划基金资助项目(GZ2013ZSF189)

摘　　要：目的观察Narcotrend监测下右美托咪啶在语言功能区手术中唤醒麻醉的临床应用效果。方法入选需进行语言功能区手术患者40例,随机分为右美托咪啶组(试验组)20例和丙泊酚复合瑞芬太尼组(对照组)20例,试验组持续输注右美托咪啶0.5μg·kg-1·min-1,对照组持续输注丙泊酚4μg·m L-1、瑞芬太尼4.5 ng·m L-1。用Narcotrend监测2组麻醉前(T0)、切皮前(T1)、开颅时(T2)、唤醒开始(T3)、唤醒开始10 min(T4),唤醒开始15 min(T5)、唤醒结束前10 min(T6)、唤醒期结束(T7)的平均动脉压、心率及麻醉深度指数(NI)值,记录唤醒持续时间和唤醒期间配合程度、呛咳次数、躁动次数。结果 2组T0、T1、T2、T3、T4时的血压、心率差异无统计学意义(P>0.05),试验组在T5、T6和T7时的平均动脉压、心率明显低于对照组(P<0.05)。2组各时点NI值差异无统计学意义(P>0.05)。试验组唤醒持续时间、配合程度显著高于对照组(P<0.05);试验组呛咳次数和体动次数显著低于对照组(P<0.05)。结论右美托咪啶用于语言功能区手术术中唤醒麻醉不降低NI值,能降低平均动脉压和心率,维持血流动力学更加稳定,不良反应发生率低。Objective To investigate the value of dexmedetomidine in intraoperative wake- up test during language functional surgery with narcotrend monitor. Methods Forty patients needing language functional surgery were randomly divided into treatment group and control group,which were pumped with dexmedetomidine（ 0. 5 μg·kg- 1·min^-1） and propofol（ 4 μg · m L^-1） combined with remifentanyl（ 4. 5 ng·m L^-1）,respectively. Narcotrend scale,heart rate（ HR） and mean arterial pressure（ MAP） were recorded at the beginning of anesthesia（ T0）,before cut skin（ T1）,when the craniotomy（ T2）,waking up（ T3）,at every 5min before 10 min of the beginning of waking up（ T4 and T5）,10 min before the end of waking up（ T6）,abd the end of wakeing up（ T7）.Arousing time and recovery quality including the degree of cooperateing,bucking and agitation were also recorded. Results There was no statistically significant difference of MAP and HR between the two groups at T0,T1,T2,T3 and T4（ P〉0. 05）. MAP,HR of treatment group at T5,T6 and T7were lower than those of control group（ P〈0. 05）. There was no difference of Narcotrend index（ NI） between the two groups（ P〉0. 05）.Arousing time and the degree of cooperateing of treatment group were significantly higher than that of control group（ P〈0. 05）. Bucking and agitation of treatment group were significantly lower than those of control group（ P〈0. 05）.Conclusion Dexmedetomidine used in language function surgery does not reduce the NI value,but can reduce the MAP and HR,maintain hemodynamic stability and reduce adverse reactions.

关 键 词：NARCOTREND 右美托咪啶 语言功能区 术中唤醒 麻醉 

分 类 号：R614[医药卫生—麻醉学] R971.2[医药卫生—外科学]