右美托咪定复合舒芬太尼在颅脑手术麻醉中的应用  

Application of dexmedetomidine combined with sufentanil in anesthesia of craniocerebral surgery

作　　者：陈米炼 彭双春 欧册华 CHEN Mi-lian;PENG Shuang-chun;OU Ce-hua(Anesthesiology Department,The Affiliated Hospital,Southwest Medical University,Luzhou 646000,China;Pain Department,The Affiliated Hospital,Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院麻醉科,四川泸州646000 [2]西南医科大学附属医院疼痛科,四川泸州646000

出　　处：《实用医院临床杂志》2020年第1期161-164,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察右美托咪定复合舒芬太尼用于颅脑手术麻醉对围术期血流动力学及麻醉深度的影响。方法选择全麻行颅脑手术患者50例,ASA I~Ⅱ级,随机分为研究组和对照组各25例。诱导前,研究组15 min内给予右美托咪定0.5μg/kg,继以0.2μg/(kg·h)泵注,以七氟烷和舒芬太尼维持麻醉;对照组给予等量生理盐水,以七氟烷和瑞芬太尼维持麻醉。术毕时均停用所有药物,对照组静注适量舒芬太尼和咪达唑仑以维持麻醉深度。比较两组围术期平均动脉压(MAP)、心率(HR)和脑电双频指数(BIS)变化及血管活性药物用量。结果研究组插管前、插管后5 min、切开硬脑膜、取瘤、术毕3~10 min时MAP明显高于对照组,插管、切皮、术毕、术毕1 min时MAP明显低于对照组;诱导前、插管至术毕10 min时HR明显低于对照组;诱导前至切皮、术毕、术毕1 min时BIS明显低于对照组(P<0.05)。两组血管活性药物用量差异无统计学意义(P>0.05)。结论右美托咪定复合舒芬太尼用于颅脑手术可增强围术期血流动力学稳定性且可维持患者在转运至监护室途中适当的麻醉深度。Objective To observe the effect of dexmedetomidine combined with sufentanil on perioperative hemodynamics and depth of anesthesia in cranial surgery.Methods Fifty patients undergoing craniocerebral surgery with general anesthesia(ASA I^lI)were randomly divided into the research group(group D)and control group(group C),25 in each group.Before induction of anesthesia,0.5μg/kg of dexmedetomidine was given within 15 minutes in the group D,followed by 0.2μg/(kg·h)pumping,and anesthesia was maintained with sevoflurane and sufentanil.The group C was given the same amount of physiological saline,and anesthesia was maintained with sevoflurane and remifentanil.At the end of surgery,all drugs were discontinued in the two groups,and sufentanil combined with midazolam were intravenously injected into the group C to maintain depth of anesthesia.The mean arterial pressure(MAP),heart rate(HR),bispectral index(BIS)and vasoactive drug dosage in the two groups during perioperative period were compared.Results MAP before intubation,5 min after intubation,incision of dura mater,tumor removal and 3~10 min after surgery was significantly higher in the group D than that in the group C.Compared to the group C,HR in the group D were significantly lower from anesthesia induction and intubation to 10 minutes after surgery,and BIS in the group D was significantly lower from anesthesia induction to incision,at the end of surgery and 1 minute after surgery(P<0 05).There was no significant difference in the amount of vasoactive drugs between the two groups(P>0.05).Conclusion Application of dexmedetomidine combined with sufentanil in anesthesia of craniocerebral surgery can enhance the perioperative hemodynamic stability of patients and maintain the appropriate anesthesia depth on the way to ICU.

关 键 词：颅脑手术 右美托咪定 舒芬太尼 血流动力学 麻醉深度 

分 类 号：R614.2[医药卫生—麻醉学]