右美托咪定对脊柱矫形术患者麻醉唤醒质量的影响  

Effects of dexmedetomidine on the wake-up quality of patients during spinal orthopaedic surgery

作　　者：孙燕[1] 谢先丰[1] 蒋蓉娟[1] 

机构地区：[1]成都市第二人民医院麻醉科,四川成都610017

出　　处：《皖南医学院学报》2015年第5期493-496,共4页Journal of Wannan Medical College

摘　　要：目的：观察全凭静脉麻醉下右美托咪定（dexmedetomidine,DEX）对脊柱矫形术患者唤醒麻醉期间唤醒质量的影响。方法：选择ASAⅡ~Ⅲ级的脊柱矫形术患者40例,随机分为两组（n=20）;D组：DEX负荷剂量1μg/kg泵注30 min,以0.5μg/（kg·h）维持;N组：以相同剂量的生理盐水替代。唤醒期间DEX和生理盐水泵注剂量降为0.2μg/（kg·h）,停用其他所有麻醉药物。记录唤醒期间呼吸恢复时间（T1）、苏醒时间（T2）、唤醒前15 min、唤醒即刻、唤醒结束和拔管时心率（HR）、平均动脉压（MAP）和BIS值、唤醒期间Ramsay镇静评分、VAS评分。结果：两组患者呼吸恢复时间、苏醒时间无统计学差异（P〉0.05）。唤醒期Ramsay镇静评分满意度D组明显高于N组（P〈0.05）,VAS评分D组比N组低（P〈0.05）,唤醒时躁动发生率N组多于D组（P〈0.05）,唤醒质量D组明显高于N组（P〈0.025）。结论：唤醒期间持续输注右美托咪定不影响患者的苏醒时间,并能改善脊柱矫形术患者的术中唤醒质量。Objective： To evaluate effects of dexmedetomidine （DEX） on the wake-up quality of patients during spinal orthopaedic surgery by total intrave- nous anesthesia. Methods：Forty patients（ ASA Ⅱ-Ⅲ ） undergoing spinal orthopedic surgery were randomized into group D and group N （ n = 20 for each）. Group D received infusion of DEX by loading dose of 1 p,g/kg for 30 rain, and maintained at the rate of 0.5 μg/（ kg · h）, and group N were given the same dose of 0.9% saline instead. During the wake-up test, the dose of DEX and saline was reduced to 0.2 μg / （ kg· h） , when all anestheties were withdrawn. Index were recorded regarding breathing recovery time （ T1 ） , awakening time （ T2 ）, heart rate （HR） 15 min before wake-up, the moment of wake-up, after wake-up and extubation, mean arterial pressure （MAP） and BIS score, scoring on the Ramsay Sedation Scale and VAS during wake-up test. Results：The two groups were not different eoneerning the breathing recovery time and awakening time（ P 〉 0. 05 ）. During the wake-up time, group D had a higher the satisfaction by Ramsay Sedation Scale （ P 〈 0.05 ）, and lower VAS score than group N （ P 〈 0.05 ）, whereas group N had higher rate of agita- tion （ P 〈 0. 025 ）, and patient in group D had better wake-up quality （ P 〈 0. 025 ）. Conclusion ： Continuous infusion of dexmeditomidine doesn＇t inhibit the awakening time, yet may improve the wake-up quality for patients during the spinal orthopedic surgery.

关 键 词：右美托咪定 脊柱矫形术 术中唤醒 唤醒质量 

分 类 号：R614[医药卫生—麻醉学]