右美托咪定辅助静脉复合全麻用于胸椎结核前后入路手术患者的效果  

Effect of de^nedetomidine as an adjunct to intravenous combined general anesthesia for anterior and posterior operation of patients with thoracic spinal tuberculosis

作　　者：翟文廷 刘伟 耿万明 刘涛 王春 高广阔 史志国 

机构地区：[1]不详 [2]首都医科大学附属北京胸科医院麻醉科,101149

出　　处：《中国防痨杂志》2016年第4期270-276,共7页Chinese Journal of Antituberculosis

摘　　要：目的探讨右美托咪定辅助丙}自酚、瑞芬太尼及注射用苯磺酸顺阿曲库铵行静脉复合全身麻醉（简称“全麻”）用于胸椎结核前后入路手术患者的效果。方法2012年1月至2015年3月，首都医科大学附属北京胸科医院收治的60例择期在全麻下行胸椎结核前后入路手术患者，美国麻醉医师协会（American Society of Anes—thesiologists，ASA）分级为I级或Ⅱ级，年龄20~50岁。采用随机数字表法将患者分成右美托咪定组和对照组各30例。右美托咪定组麻醉诱导前20min静脉泵注0．5／zg·kg-1·h。右美托咪定，手术结束前30min停止输注。对照组不应用右美托咪定。分别记录两组患者进入手术室后（T0，基础值），气管插管后1min（T1），患者由仰卧变为俯卧位（T2），后路手术切皮1rain（T3），手术30min（T4），手术60rain（T5），手术90min（L），患者由俯卧变为左侧卧（T1），开胸手术切皮1min（T8），手术60rain（T9），手术结束时（T10），气管拔管时（T11）时的有创平均动脉血压（MAP）、心率（HR）、脑电双频指数（BIS）。记录丙泊酚、瑞芬太尼、尼卡地平的用量。手术结束至拔管时间，苏醒时烦躁不安，术后寒颤情况，术中出血量，尿量。采用SPSS19．0软件进行分析，所有计量资料均采用“X±S”表示，组内比较采用配对t检验，组问比较采用两样本t检验，计数资料的比较采用X2检验，P〈0．05为差异有统计学意义。结果与对照组比较，右美托咪定组MAP、HR在T1～T11时较低，对照组MAP和HR分别为（108±9）TnrnHg（1mmHg-0．133kPa）和（99±15）次／min、（95±14）InrnHg和（88±14）次／min、（105±15）mmHg和（101±16）次／min、（85±16）mmHg和（86±17）次／min、（82±13）mmHg和（85±14）次／min、（80±15）mmHg和（82±lO）次／min、（84±14）mmHg和（84±15）次／min、（88±10）mmHg和（85±16）次／min、�Objective To investigate the effect of dexmedetomidine as an adjunct to intravenous combined ane- sthesia using propofol, remifentanil and benzene sulfonic acid ammonium salt for anterior and posterior operation of patients with thoracic spinal tuberculosis. Methods From January 2012 to March 2015, 60 thoracic spinal tubercu- losis patients admitted in Beiiing Chest Hospital, Capital Medical University were undergone general anesthesia for anterior and posterior selective operation. All patients with I or II grade of American Society of Anesthesiologists （ASA） aged from 20 to 50 years old were divided randomly into dexmedetomidine group andcontrol group according to the result of random number table. Patients in dexmedetomidine group received an infusion dexmedetomidine （0. 5 μg · kg -1 ·h-l） at 20 mins before anesthesia induction and stopped at 30 mins before surgery. Patients in con- trol group didn＇t receive dexmedetomidine. Mean arterial pressure （MAP）, heart rate （HR） and bispectral index （BIS） were measured at the time of entering the operation room （To）, 1 minute after intubation （T1）, supine to prone position （T2）, and I minute （T3）, 30 mins （T4）, 60 mins （%）, 90 mins （%） after beginning of posterior opera- tion, prone to the left lying prone （T7）, and 1 minute （T8）, 60 mins （T9） after beginning of anterior operation, the end of operation （T10）, extubation （Tu）. The dosage of propofol, remifentanil and nicardipine at the end of operation, the time of extubation from the end of operation, dysphoria when waking up, postoperative shivering, the volume of intraoperative bleeding and urinary were recorded. Using the SPSS software with version 19.0, all the measurement data were displayed as mean number plus or minus standard deviation. Intra-group comparison and groups comparison were used with paired t test and with independent-samples t test, respectively. Enumeration data were compared with Chi square test. P〈0.05 was considered sign

关 键 词：右美托咪定 麻醉药 麻醉 静脉 结核 脊柱/外科手术 

分 类 号：R614[医药卫生—麻醉学]