右美托咪定不同镇静深度对区域麻醉患者外显记忆和内隐记忆的影响  

Effects of dexmedetomidine at different levels of sedation on explicit and implicit memory in patients with regional anesthesia

作　　者：刘琳琳 邱雁 简超君 贯璇 王英姿 刘克玄[2] LIU Linlin;QIU Yan;JIAN Chaojun;GUAN Xuan;WANG Yingzi;LIU Kexuan(Department of Anesthesiology,The University of Hong Kong-Shenzhen Hospital,Shenzhen 518000,China)

机构地区：[1]香港大学深圳医院麻醉科,518000 [2]南方医科大学南方医院麻醉科

出　　处：《临床麻醉学杂志》2020年第7期665-668,共4页Journal of Clinical Anesthesiology

基　　金：深圳市科技计划项目(JCYJ20160429190235638);深圳市卫生计生系统科研项目(201601036)。

摘　　要：目的观察右美托咪定不同镇静深度对区域麻醉患者外显记忆和内隐记忆的影响。方法择期行区域麻醉的患者32例,男19例,女13例,年龄18~50岁,ASAⅠ或Ⅱ级。采用随机数字表法将患者随机分为两组:浅镇静组(BIS 60~80)和深镇静组(BIS 40~60),每组16例。给药前,先予清醒听词学习,在持续泵注右美托咪定时,给予镇静听词学习。记录患者用药前后警觉-镇静评分(OAA/S评分)。停药4 h后,通过加工分离程序评估外显记忆和内隐记忆成绩。结果浅镇静组外显记忆成绩为(-0.05±0.15)分,内隐记忆成绩为(0.06±0.11)分。深镇静组外显记忆成绩为(0.04±0.10)分,内隐记忆成绩为(-0.06±0.11)分。浅镇静组内隐记忆成绩明显高于0(P<0.05)。结论在右美托咪定浅镇静和深镇静状态下均可抑制外显记忆形成,但只能在深镇静时消除内隐记忆。Objective To assess the effects of different sedation depths of dexmedetomidine on explicit and implicit memory in patients with regional anesthesia. Methods Thirty-two patients, 19 males and 13 females, aged 18-50 years, falling into ASA physical status Ⅰ or Ⅱ underwent elective regional anaesthesia and were randomly divided into mild sedation group(BIS 60-80) and deep sedation group(BIS 40-60). Auditory stimulus was presented when the patients were awake, and a second auditory stimulus was presented with continuous dexmedetomidine sedation. OAA/S score was recorded before and after sedation. Explicit and implicit memory was assessed by process dissociation procedure after four hours of discontinuation. Results The memory score in the mild sedation group was(-0.05 ± 0.15) for explicit memory and(0.06 ± 0.11) for implicit memory. The memory score in the deep sedation group was(0.04 ± 0.10) for explicit memory and(-0.06 ± 0.11) for implicit memory. The implicit memory score was significantly greater than zero in the mild sedation group(P<0.05). Conclusion The formation of explicit memory can be inhibited by dexmedetomidine in the state of mild sedation and deep sedation, but implicit memory memory only can be eliminated in the state of deep sedation.

关 键 词：外显记忆 内隐记忆 右美托咪定 加工分离程序 镇静 

分 类 号：R614[医药卫生—麻醉学]