右旋美托咪定复合丙泊酚在全麻宫腔镜手术患者脑电分段功率谱的特点及意义  

Characteristics and Significance of Dexmedetomidine combined with Propofol in Narcotrend EEG Segmentation Power Spectrum undergoing Hysteroscopic Surgery under General Anesthesia

作　　者：周毛[1] 温婧 严文婵 彭玉璇[1] ZHOU Mao;WEN Jing;YANWen-chan;PENG Yu-xuan(Department of Anaesthesia,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou,510120)

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,510120

出　　处：《岭南急诊医学杂志》2022年第6期538-541,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨右旋美托咪定(右美)复合丙泊酚在宫腔镜手术患者脑电分段功率谱的变化特点。方法:将2020年12月至2021年6月行宫腔镜手术患者随机分为对照组(R组,n=30)给予生理盐水、右美1组(D1组,n=30)给予右美0.5μg/kg,右美2组(D2组,n=30)给予1μg/kg。三组患者均靶控输注丙泊酚,直至意识消失开始手术。比较三组患者的基础状态(T1)、右美停药时(T2)、手术开始时(T3)、手术开始后5 min(T4)、手术结束后10 min(T5)的生命体征及脑电数据。结果:达到满意镇静效果后,与基础值相比,T2时D1和D2组β功率百分比均降低,T2、T3时D2组β功率百分比低于R组;T4时D2组θ功率百分比高于R组;T2、T5时D2组δ功率百分比高于D1和R组。T4时D2组丙泊酚靶控血药浓度低于D1组,D1组低于R组。结论:右美1μg/kg可降低丙泊酚给药量,减少呼吸抑制和苏醒延迟的发生率。Narcotrend变化对使用丙泊酚复合右美的宫腔镜手术患者麻醉深度有临床意义。Objective:To explore the change characteristics of fractional EEG power spectrum of dexmedetomidine combined with propofol in patients undergoing hysteroscopic surgery under general anesthesia.Methods:Patients undergoing selective hysteroscopic operation were randomly divided into control group(R group,n=30)was given normal saline,dexmedetomidine group D1(D1 group,n=30)was given dexmedetomidine 0.5μg/kg,dexmedetomidine group 2(D2 group n=30)was given dexmedetomidine 1μg/kg from Dec 2020 to Jun 2021.Patients were given target-controlled infusion of propofol in all three groups until they lost consciousness and surgery began.The vital signs and Narcotrend EEG power spectrum of patients in the three groups were compared in basal state(T1),immediately after dexmedetomidine withdrawal(T2),at the beginning of operation(T3),5 minutes after operation(T4),and 10 minutes after operation(T5).Results:After satisfactory sedation effect was achieved(RSS 4-5),compared with baseline value in all three groups,at T2,the power percentage ofβdecreased in D1 and D2 groups.AtT2 and T3,The percentage ofβpower in D2 group was lower than that in R group.At T4,theθpower percentage in D2 group was higher than that in R group.At T2 and T5,the percentage ofδpower in D2 group was higher than that in D1 and R group.At T4,the target-controlled plasma concentration of propofol in D2 group was lower than that in D1 group,and that in D1 group was lower than that in R group.Conclusion:It can reduce the blood concentration of propofol to meet the surgical requirements and reduce the incidence of respiratory depression and delayed wake up using dexmedetomide 1μg/kg.Propofol combined with dexmedetomidine is used in hysteroscopic surgery,and the change of Narcotrend has guiding significance to the depth of anesthesia.

关 键 词：脑电图 Narcotrend监护仪 右旋美托咪定 丙泊酚 宫腔镜手术 

分 类 号：R614[医药卫生—麻醉学]