右美托咪定术中镇静对脑深部电刺激术后疗效影响的回顾性研究  

The influence of dexmedetomidine sedation on the postoperative efficacy of deep brain stimulation:A retrospective study

作　　者：刘清海[1] 刘扬[1] 金笛 李京生[1] 冯华[1] 范隆[1] 王天龙[1] Liu Qinghai;Liu Yang;Jin Di;Li Jingsheng;Feng Hua;Fan Long;Wang Tianlong(Department of Anesthesiology,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053

出　　处：《国际麻醉学与复苏杂志》2020年第12期1136-1139,共4页International Journal of Anesthesiology and Resuscitation

基　　金：北京市医院管理局临床医学发展专项经费(ZYLX201818)。

摘　　要：目的回顾性研究脑深部电刺激术中右美托咪定(dexmedetomidine,Dex)镇静对术后疗效的影响。方法回顾2016年6月—2019年5月在首都医科大学宣武医院行丘脑底核脑深部电刺激术的患者191例,按照是否应用Dex镇静分为镇静组(98例)和对照组(93例)。主要结局指标为术后2周开机改善率。次要结局指标为脑深部电极植入期间的SBP、心率、SpO2,BIS,患者手术时间、麻醉时间、住院天数,围手术期并发症发生情况(包括苏醒期谵妄、低氧血症、空气栓塞、颅内出血、癫痫)。结果镇静组患者术中SBP、术中心率、术中BIS低于对照组(P<0.05),镇静组苏醒期谵妄发生率低于对照组(P<0.05)。两组患者术前及术后统一帕金森病评分量表第三部分(Unified Parkinson's Disease Rating ScaleⅢ,UPDRSⅢ)评分、术后2周开机改善率及围手术期并发症发生情况差异无统计学意义(P>0.05)。结论Dex镇静不会降低脑深部电刺激术后2周开机疗效。Objective To retrospectively study the postoperative efficacy of dexmedetomidine(Dex)sedation during deep brain stimulation on postoperative efficacy.Methods From 1 June 2016 to 31 May 2019,191 patients who underwent deep brain stimulation of the subthalamic nucleus in Xuanwu Hospital were reviewed.The patients were divided into the sedation group(n=98)and control group(n=91),it depends on whether Dex was used for sedation.The primary outcome was the efficacy of the stimulator on two weeks after the operation.The secondary outcome was systolic blood pressure(SBP),heart rate,pulse oxygen saturation(SpO2)during deep brain electrodes implantation,Bispectral index(BIS),duration of surgery,duration of anesthesia,length of stay,perioperative com‐plications,including emergence delirium,hypoxemia,air embolism,intracranial hemorrhage,epilepsy.Results In the sedation group,intraoperative SBP,heart rate,and bispectral index(BIS)were lower than those in the control group(P<0.05),and the incidence of emergence delirium in the sedation group was lower than that in the control group(P<0.05).There were no statistically significant dif‐ferences between the two groups in preoperative and postoperative Unified Parkinson's Disease Rating ScaleⅢ(UPDRSⅢ)score,deep brain stimulation improvement rate of 2 weeks after surgery,and perioperative complication incidence(P>0.05).Conclusions Dex sedation did not reduce the efficacy of deep brain stimulator two weeks after surgery.

关 键 词：丘脑底核 脑深部电刺激 右美托咪定 镇静 谵妄 

分 类 号：R614[医药卫生—麻醉学]