右美托咪定与丙泊酚复合麻醉对脑膜瘤手术患者的麻醉效果及对血流动力学及脑组织的保护作用  

Effects of Dexmedetomidine and Propofol Combined Anesthesia on Anesthesia,Hemodynamics and Brain Protection in Patients Treated with Meningioma Surgery

作　　者：申素峰[1] 李景义 胡强夫[1] SHEN Sufeng;LI Jingyi;HU Qiangfu(The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,450052)

机构地区：[1]郑州大学第五附属医院,450052

出　　处：《实用癌症杂志》2022年第12期1971-1974,共4页The Practical Journal of Cancer

摘　　要：目的探讨右美托咪定与丙泊酚复合麻醉对脑膜瘤手术患者的麻醉效果及对血流动力学及脑组织的保护作用。方法收集脑膜瘤手术患者120例,采用随机数字表法进行分组,即丙泊酚组和右美托咪定组,均60例。丙泊酚组对脑膜瘤手术患者采用丙泊酚注射液[3~10 mg/(kg·h)]麻醉,右美托咪定组对脑膜瘤手术患者采用盐酸右美托咪定注射液[0.2~1.0μg/(kg·h)]麻醉。分别于麻醉诱导前(T0)、切开硬脑膜时(T1)、去除肿瘤组织时(T2)、手术结束时(T3)、术后1 d(T4)监测患者HR、MAP、ScVO2、NSE、S100β指标,并记录苏醒时间、拔管时间、警觉/镇静(OAA/S)评分,同时进行安全性评估。结果①T0、T4时刻2组HR、MAP比较,P>0.05;T1、T2、T3时刻2组HR、MAP比较,P<0.05,且右美托咪定组HR、MAP数值均显著低于丙泊酚组(P<0.05)。②T0时刻2组ScVO2、NSE、S100β水平比较,P>0.05;T1、T2、T3、T4时刻2组ScVO2、NSE、S100β水平比较,P<0.05,且右美托咪定组ScVO2水平均显著高于丙泊酚组(P<0.05),右美托咪定组NSE、S100β水平均显著低于丙泊酚组(P<0.05)。③右美托咪定组苏醒时间、拔管时间均显著低于丙泊酚组,右美托咪定组OAA/S评分显著高于丙泊酚组(P<0.05)。④2组患者不良反应总发生率比较,P>0.05。结论与丙泊酚复合麻醉比较,右美托咪定对脑膜瘤手术患者麻醉效果更理想,对脑组织具有保护作用,能有效维持血流动力学的稳定,安全性高。Objective To investigate the anesthetic effect of dexmedetomidine and propofol combined anesthesia in patients with meningioma surgery and the protective effect on hemodynamics and brain tissue.Methods A total of 120 patients with meningioma were randomly divided into propofol group and dexmedetomidine group,60 cases in each group.Patients in the propofol group were anesthetized with propofol injection[3~10 mg/(kg·h)],and patients in the dexmedetomidine group were anesthetized with dexmedetomidine hydrochloride injection[0.2~1.0μg/(kg·h)].HR,MAP,ScVO2,NSE and S100βwere monitored before anesthesia induction(T0),when dura incision was made(T1),when tumor tissue was removed(T2),at the end of surgery(T3)and one day after surgery(T4),and the recovery time,extubation time and alert/sedation(OAA/S)score were recorded.Security assessment is also performed.Results①Comparison of HR and MAP between the two groups at T0 and T4,P>0.05;The HR and MAP values of dexmedetomidine group were significantly lower than those of propofol group at time T1,T2 and T3(P<0.05).②The levels of ScVO2,NSE and S100βin the 2 groups at T0 were compared,P>0.05;The levels of ScVO2,NSE and S100βin the 2 groups at T1,T2,T3 and T4 were compared,P<0.05,and the levels of ScVO2 in the dexmedetomidine group were significantly higher than those in the propofol group(P<0.05),and the levels of NSE and S100βin the dexmedetomidine group were significantly lower than those in the propofol group(P<0.05).③The recovery time and extubation time in dexmedetomidine group were significantly lower than those in propofol group,and the OAA/S score in dexmedetomidine group was significantly higher than that in propofol group(P<0.05).④Comparison of the total incidence of adverse reactions between the 2 groups(P>0.05).Conclusion Compared with propofol combined anesthesia,dexmedetomidine has better anesthetic effect in patients with meningioma surgery,has protective effect on brain tissue,and can effectively maintain hemodynamic stability with high safety.

关 键 词：脑膜瘤 右美托咪定 丙泊酚 麻醉 血流动力学 脑保护 

分 类 号：R739.45[医药卫生—肿瘤]