右美托咪定用于脊柱侧弯矫形术术中唤醒临床观察  

Clinical Effect of Dexmedetomidine on the Quality of Wake-up Test During Scoliosis Surgery

作　　者：刘树春[1] 赵倩[1] 汪鑫[1] 刘兴敏[2] 

机构地区：[1]贵州省人民医院麻醉科,贵州贵阳550002 [2]贵阳医学院附院麻醉科,贵州贵阳550004

出　　处：《贵阳医学院学报》2016年第4期487-490,共4页Journal of Guiyang Medical College

摘　　要：目的:研究右美托咪定(Dex)对脊柱侧弯矫形术术中唤醒质量的影响。方法:26例行脊柱侧弯矫形术的患者随机均分成Dex组和对照组;Dex组麻醉前应用Dex 0.5μg/kg泵注20 min,术中持续泵注0.2μg/(kg·h),对照组泵注相同剂量生理盐水;分别观察麻醉诱导时(T1)、停七氟烷时(T2)、遵指令活动双手时(T3)、遵指令活动双足时(T4)的血压(MAP)、心率(HR)变化及T2、T3、T4时的脑电双频指数(BIS)值,记录麻醉诱导至停七氟烷期间七氟烷、丙泊酚和瑞芬太尼的用量、唤醒时间和唤醒实验质量评分。结果:与对照组比较,Dex组丙泊酚与瑞芬太尼用量、T3时MAP及T4时MAP、HR、BIS均显著降低(P<0.05);Dex组唤醒试验质量评分显著优于对照组(P<0.05)。结论:Dex联合七氟烷-丙泊酚-瑞芬太尼静吸复合全麻用于脊柱侧弯矫形术时,血流动力学平稳,显著改善唤醒质量,不延长唤醒时间。Objective： To investigate the effect of dexmedetomidine（ Dex） on the quality of walke-up test during scoliosis orthopedic surgery. Methods： 26 patients undergoing posterior scoliosis surgery were randomly divided into Dex group and control group. In Dex group,0. 5 μg / kg Dex were infused by pump injection before anesthesia induction followed by continuous pump injection of 0. 2 μg /（ kg·h） in surgery while control group received equal volume of normal saline. MAP and HR were observed before anesthesia induction（ T1）,at the beginning of wake-up test（ T2）,hands moving followed with command（ T3）,and feet moving followed with command（ T4）. BIS were observed at T2,T3 and T4 as well as. Total consumption of sevoflurane,propofol and remifentanil during the period from T1 to T2 was recorded. Wake-up time and wake-up quality were also recorded and evaluated. Results： Compared with control group,total consumption of propofol and remifentanil in Dex group was significantly lower（ P〈 0. 05）,MAP at T3 and MAP,HR and BIS at T4 in Dex group decreased significantly（ P〈 0. 05）,and the wake-up quality of Dex group was significantly better（ P〈 0. 05）. Conclusion： Dex infusion can improve wake-up quality and don＇t prolong wake-up time during scoliosis orthopedic surgery under combined intravenous and inhalation anesthesia with propofol,remifentanil and sevoflurane.

关 键 词：唤醒试验 右美托咪定 脊柱侧弯矫形术 七氟烷 丙泊酚 瑞芬太尼 

分 类 号：R614.41[医药卫生—麻醉学]