右美托咪定在功能神经外科手术麻醉中的临床应用分析  

Clinical application of dexmedetomidine in anesthesia for functional neurosurgery

作　　者：周蔚蓝[1] 黄晓霞[1] 乐新会[1] 

机构地区：[1]金华市中心医院麻醉科,浙江金华321000

出　　处：《中华全科医学》2017年第4期597-599,728,共4页Chinese Journal of General Practice

摘　　要：目的探讨右美托咪定在功能神经外科手术麻醉中的临床疗效,为临床麻醉的选择提供理论依据。方法选择金华市中心医院2015年5月—2016年5月收治的337例手术患者,随机分为观察组(169例)和对照组(168例)。观察组予以右美托咪定(1μg/kg,10 min)静脉注射,以0.4μg/(kg·h)的速度持续静脉泵入,对照组予以等量生理盐水静脉注射,2组均以丙泊酚静脉麻醉诱导与维持。于诱导前、术毕、苏醒时3个时间点记录患者MAP、HR、Sp O2、Ramsay镇静评分、RR、OAA/S镇静评分,比较2组唤醒期应答能力及不良反应发生情况。采用SPSS 19.0对数据进行统计学处理。结果术毕、苏醒时,观察组MAP、HR均低于对照组(P<0.05),Ramsay镇静评分均大于对照组(P<0.05)。术毕OAA/S镇静评分小于对照组,苏醒时大于对照组(P<0.05)。观察组唤醒期应答满意148例(87.57%),显著高于对照组的121例(72.02%,P=0.021)。观察组不良反应发生7例(4.14%),低于对照组的11例(6.55%),差异无统计学意义(P=0.326)。结论对功能神经外科手术患者而言,采用右美托咪定麻醉临床疗效显著,可以有效发挥镇静效果,唤醒期应答能力高,值得推广应用。Objective To investigate the effect of dexmedetomidine in anesthesia for functional neurosurgery,and to provide scientific theoretical basis for clinical selection of anesthesia. Methods A total of 337 patients undergoing functional neurosurgery in our hospital from May,2015 to May,2016 were randomly divided into observation group（ n = 169） and control group（ n = 168）. The observation group received dexmedetomidine intravenous injection（ 1 μg/kg,10 min）,continuous intravenous infusion of 0. 4 μg/（ kg·h）,while the control group was given normal saline by intravenous injection. Both groups were given intravenous anesthesia induction and maintenance with propofol. The level of MAP,HR,Sp O2,Ramsay sedation score,RR,OAA/S sedation score at the time points before the induction,after the surgery and awareness recovery were recorded and compared. The response capability during wake-up period and adverse reactions were also compared between the two groups. SPSS 19 was used for statistical data processing. Results The level of MAP and HR in the observation group were all statistically lower than those of in the control group after the surgery and awareness recovery（ P〈0. 05）,and the Ramsay sedation score of the observation group were all statistically higher than that of the control group respectively（ P〈0. 05）. After the surgery,the OAA/S sedation score was statistically less in the observation group than that in the control group. However,OAA/S sedation score during awareness recovery was statistically greater in the observation group than that of in the control group（ P〈0. 05）. One hundred and forty-eight cases（ 87. 57%） were response significantly during wake-up period in the observation group and which was higher than that in the control group（ 121 cases,72. 02%） P = 0. 021. 7 cases（ 4. 14%） with adverse reactions in the observation group was lower than 11 cases（ 6. 55%） in the control group of,and there was no statistical difference（ P = 0. 326）. Conclusion The

关 键 词：功能神经外科 右美托咪定 麻醉 镇静 

分 类 号：R651.11[医药卫生—外科学] R971.2[医药卫生—临床医学]