右美托咪定复合麻醉对腹腔镜全子宫切除术患者术中脑氧饱和度的影响  

Effect of dexmedetomidine-based anesthesia on cerebral oxygen saturation in patients undergoing total laparoscopic hysterectomy

作　　者：杨茜茜 王兵 朱梦雪 程志 赵志斌 张小宝 Yang Qianqian;Wang Bing;Zhu Mengxue;Cheng Zhi;Zhao Zhibin;Zhang Xiaobao(Department of Anesthesiology,The Affiliated Lianyungang Hospital of Xuzhou Medical University,Lianyungang 222000,China;Department of Anesthesiology,The Affiliated Hospital of Kangda College of Nanjing Medical University,Lianyungang 222000,China)

机构地区：[1]徐州医科大学附属连云港医院麻醉科,连云港222000 [2]南京医科大学康达学院附属医院麻醉科,连云港222000

出　　处：《中华麻醉学杂志》2023年第11期1307-1310,共4页Chinese Journal of Anesthesiology

基　　金：徐州医科大学附属连云港医院临床究基金(LC13);连云港市521工程资助。

摘　　要：目的评价右美托咪定复合麻醉对腹腔镜全子宫切除术患者术中脑氧饱和度(rSO2)的影响。方法选择拟行择期腹腔镜全子宫切除术患者50例, ASA分级Ⅰ或Ⅱ级, 年龄20 ~ 64岁, 采用随机数字表法分为2组(n=25):常规组(C组)和右美托咪定复合麻醉组(D组)。采用脑氧饱和度监测仪监测双侧rSO2。D组麻醉诱导前静脉泵注右美托咪定0.5 μg/kg, 10 min后改为0.5 μg·kg^(-1)·h^(-1)维持, 手术结束前30 min停药。C组静脉泵注等容量生理盐水。2组其余麻醉方案相同。于入室至诱导后2 min(D1)、诱导后>2 min至气管插管完成(D2)、气管插管完成后至切皮结束(D3)、切皮后至完成气腹(D4)、气腹后至完成Trendelenburg体位(D5)、Trendelenburg体位20 min内(D6)、>20 ~40 min(D7)、>40~60 min(D8)、>60 min至恢复平卧位10 min(D9)记录双侧rSO2的最大值(LrSO2max、RrSO2max)和最小值(LrSO2min、RrSO2min)。记录术中LrSO2>60%基础值~<75%基础值、≤60%基础值的发生情况。结果与D1时比较, C组D4-D8时LrSO2min、LrSO2max、RrSO2min、RrSO2max降低(P<0.05), D组其余时期上述指标差异无统计学意义(P>0.05);与C组比较, D组D4-D8时LrSO2min、LrSO2max、RrSO2min、RrSO2max升高(P<0.05)。D组术中未见双侧rSO2<75%基础值发生。结论右美托咪定复合麻醉可提高腹腔镜全子宫切除术患者术中rSO2。Objective To evaluate the effect of dexmedetomidine-based anesthesia on cerebral oxygen saturation in the patients undergoing total laparoscopic hysterectomy.Methods Fifty American Society of Anesthesiologists Physical Status classificationⅠorⅡpatients,aged 20-64 yr,undergoing elective total laparoscopic hysterectomy,were divided into 2 groups(n=25 each)using a random number table method:conventional group(C group)and dexmedetomidine group(D group).Bilateral regoinal oxygen saturation(rSO2)was monitored using a cerebral oxygen saturation monitor.In D group,dexmedetomidine was intravenously infused as a bolus of 0.5μg/kg before anesthesia induction,and 10 min later dexmedetomidine was then given by an infusion of 0.5μg·kg^(-1)·h^(-1) until 30 min before the end of operation.The equal volume of normal saline was given instead in C group.The remaining anesthesia regimen was the same in two groups.The maximum(LrSO2max,RrSO2max)and minimum(LrSO2min,RrSO2min)of bilateral rSO2 were recorded from entry to 2 min after induction(D1),from>2 min after induction to completion of tracheal intubation(D2),from completion of tracheal intubation to the end of skin incision(D3),from skin incision to completion of pneumoperitoneum(D4),from pneumoperitoneum to completion of Trendelenburg position(D5),within 20 min of Trendelenburg position(D6),>20-40 min of Trendelenburg position(D7),>40-60 min of Trendelenburg position(D8),and from>60 min of Trendelenburg position to 10 min after return to supine position(D9).The occurrence of 60%baseline value<rSO2<75%baseline value and rSO2≤60%baseline value were also recorded.Results Compared with D1 period,LrSO2min,LrSO2max,RrSO2min and RrSO2max were significantly decreased in D4-D8 periods in C group(P<0.05),and no significant change was found in the parameters mentioned above in the other periods in D group(P>0.05).Compared with C group,the LrSO2min,LrSO2max,RrSO2min,and RrSO2max were significantly increased in D4-D8 periods in D group(P<0.05).No bilateral rSO2<75%baseline value was

关 键 词：右美托咪啶 脑 氧 腹腔镜检查 子宫切除术 

分 类 号：R614[医药卫生—麻醉学]