异丙酚复合右美托咪定麻醉对术中知晓和术后记忆的影响

发布时间：2018-05-28 00:06

本文选题：右美托咪定 + 异丙酚　；参考：《郑州大学学报(医学版)》2015年05期

【摘要】：目的:探讨异丙酚复合右美托咪定对术中知晓和术后记忆的影响。方法:180例行择期手术的全麻患者分为观察组(A组、B组、C组)和对照组(A0组、B0组、C0组)共6组,先行靶控输注异丙酚,再分别输注右美托咪定(观察组)或生理盐水(对照组)。观察记录手术过程中各组患者血流动力学指标以及脑电双频谱指数(BIS)和麻醉深度指数(CSI)的变化,并随访和记录术中知晓和术后记忆的情况。结果:麻醉诱导后和气管插管后各时间点观察组fH和pMA低于对照组(P0.05)。对照组CI明显下降,观察组均无明显变化。插管后观察组pCV明显高于对照组(P0.05)。所有患者在T2时点BIS和CSI值的差异有统计学意义(P0.05)。在给予右美托咪定后A、B组患者从T3后BIS和CSI与其对照组比较下降(P0.05)。C组患者各时点BIS值与C0组比较无明显改变,但CSI值仍然下降(P0.05)。除A、A0组外所有患者均未回忆出术中事件及相关的梦。结论:异丙酚复合右美托咪定较单独靶控输注异丙酚全身麻醉具有更好的增强效果,减少术中知晓和术后记忆,避免了患者的术后焦虑等心理上并发症的发生。
[Abstract]:Objective: to investigate the effect of propofol combined with dexmetidine on intraoperative knowledge and postoperative memory. Methods one hundred and eighty patients undergoing elective operation were divided into 6 groups: observation group (group A) and control group (group B). Propofol was injected with target control and dexmetomidine (observation group) or normal saline (control group) respectively. The changes of hemodynamic indexes, bispectral index (BIS) and depth of anesthesia index (CSI) were recorded during the operation, and the intraoperative and postoperative memory were recorded. Results: the FH and pMA in the observation group were lower than those in the control group after anesthesia induction and tracheal intubation. In the control group, CI decreased significantly, but no significant change was found in the observation group. After intubation, the pCV in the observation group was significantly higher than that in the control group (P 0.05). The difference of BIS and CSI in all patients at T 2 was statistically significant (P 0.05). Compared with the control group, BIS and CSI in group A B decreased from T 3 to control group. The BIS values of group C were not significantly different from those of group C, but the value of CSI was still decreased in group C (P 0.05). No intraoperative events and related dreams were recalled in all patients except group A A 0. Conclusion: propofol combined with dexmetidine has a better enhancement effect than target-controlled infusion of propofol in general anesthesia, reduces intraoperative knowledge and postoperative memory, and avoids psychological complications such as postoperative anxiety.
【作者单位】：郑州大学第二附属医院麻醉科;
【分类号】：R614

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