【摘要】 目的右美托咪定1.0μg/kg静脉泵用于颅脑外科手术中的可行性。方法选择60例ASAⅠ～Ⅱ级择期颅脑手术患者,随机分为右美托咪定组(D组)及对照组(C组)。麻醉诱导前20min:D组右美托咪定按1.0μg/kg总量加入至20mL生理盐水中,微量泵10min内输注完毕;C组等量生理盐水微量泵10min内输注完毕。观察2组患者入室(T0)、切皮(T1)、术中1h(T2)、术中2h(T3)、拔管时(T4)的SBP、DBP和HR变化及患者麻醉维持期不同丙泊酚TCI的靶浓度例数。结果 2组患者的性别、年龄、体质量及手术时间差异均无统计学意义(P>0.05)。与入室比较,D组SBP、DBP、HR在切皮和拔管时无显著变化,C组SBP、DBP显著升高,HR显著增快(P<0.05);与D组比较,C组在切皮和拔管时SBP、DBP显著升高(P<0.05),HR显著增快(P<0.05)。D组在麻醉维持期丙泊酚TCI血浆靶浓度≤2.5μg/mL的病例数明显多于C组(P<0.05)。结论右美托咪定(1.0μg/kg)可使血流动力学平稳,不良反应少,可安全有效用于颅脑外科手术患者。更多还原

【Abstract】 Objective To investigate the effect of dexmedetomidine compounding general anesthesia on neurosurgical patients.Methods 60 patients with ASA Ⅰ~Ⅱ rank were randomly divided into the dexmedetomidine group(30 cases,group D) and the control group(30 cases,group C).At 20 min before anesthesia induction,a continuous infusion of dexmedetomidine(1.0 μg/kg,dissolved in 20 mL saline in group D) or 20 mL saline(in group C) were administrated for 10 min by micropump,respectively.The hemodynamic changes of SBP,DBP and HR and the target concentration of propofol were detected at T0,T1,T2,T3 and T4 time points in both groups.Results There were no differences between two groups on sex,age,weight and duration time(P>0.05).Compared with T0 time point,the levels of SBP,DBP and HR had no significant change in group D or were significantly increased in group C at T1 and T4 time points in skin incision and extubation;The levels of SBP,DBP and HR in group C were higher than these in group D,however,the concentration of serum propofol(≤ 2.5 μg/ml) in group D was higher than that in group C.Conclusion Dexmedetomidine has a characteristic of stable hemodynamic and less adverse reaction,which can be safely used for the neurological surgery.更多还原