右美托咪定对神经外科手术患者局部脑氧饱和度和术后认知功能的影响  

The effect of dexlansoprazole on local cerebral oxygen saturation and postoperative cognitive function in neurosurgery

作　　者：薛延召 董铁立[1] XUE Yanzhao;DONG Tieli(Department of Anesthesiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院麻醉科,河南郑州450014

出　　处：《中国实用神经疾病杂志》2018年第23期2617-2622,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨神经外科手术中采用右美托咪定麻醉对患者局部脑氧饱和度(rSO_2)和术后认知功能的影响。方法选取郑州大学第二附属医院2015-12—2017-12的80例神经外科手术患者进行麻醉研究,随机分为试验组和对照组各40例,对照组全麻气管插管后静脉泵注七氟烷,试验组全麻气管插管后静脉泵注右美托咪定,术中使用脑氧饱和度监测仪监测rSO_2。记录入室时(T_0)、诱导插管后(T_1)、手术后60min(T_2)和苏醒后(T_3)的rSO_2、平均动脉压(MAP)、动脉血二氧化碳分压(PaCO_2)和动脉血氧分压(PaO_2)。术前1d、术后1d和3d使用蒙特利尔认知功能评分量表(MoCA)对患者的认知功能障碍进行评价。记录术后患者发生躁动和恶心呕吐的情况。结果试验组和对照组的T_(0-3)的rSO_2、MAP、PaCO_2和PaO_2差异无统计学意义(P>0.05);试验组手术后1～3d的认知功能评分明显高于对照组,差异具有统计学意义(P<0.05);试验组躁动和恶心呕吐发生率与对照组比较差异无统计学意义(P>0.05)。结论神经外科手术中采用右美托咪定麻醉对患者局部脑氧饱和度的影响不明显,但是会助于患者术后的认知功能的恢复。Objective To study the effect of dexmetomidine anesthesia on regional cerebral oxygen saturation(rSO 2)and postoperative cognitive function in neurosurgery.Methods From December 2015 to December 2017,80 patients undergoing neurosurgery in our hospital were randomly divided into two groups:the experimental group(n=40)and the control group(n=40).The control group received intravenous infusion of sevoflurane after tracheal intubation under general anesthesia.In the experimental group,dexmetomidine was injected intravenously after endotracheal intubation under general anesthesia,and rSO 2 was monitored by cerebral oxygen saturation monitor during operation.rSO 2,mean arterial pressure(MAPP),arterial carbon dioxide partial pressure(PaCO 2)and arterial partial pressure of oxygen(PaO 2)were recorded Time of entry(T0),after induction of intubation(T1),60 min after operation(T2)and after awakening(T3).The patients with cognitive dysfunction were evaluated with the Montreal Cognitive function scale(MoCA)1 day before operation,1 day and 3 days after operation.Postoperative restlessness and nausea and vomiting were recorded.Results There was no significant difference in rSO 2,MAP,PCO 2 and PaO 2 between the experimental group and the control group(P>0.05),and the scores of cognitive function in the experimental group were significantly higher than those in the control group at 1-3 days after operation(P<0.05).The rates of restlessness and nausea and vomiting in the trial group were not significantly different from those in the control group(P>0.05).Conclusion The effect of dexmedetomidine anesthesia on local cerebral oxygen saturation in the Department of neurosurgery is not obvious,but it will help the recovery of cognitive function after operation.

关 键 词：神经外科手术 右美托咪定 脑氧饱和度 认知功能 

分 类 号：R614[医药卫生—麻醉学]