Narcotrend监测下右美托咪啶在语言功能区手术中唤醒麻醉的临床研究

发布时间：2018-10-20 10:36

【摘要】：目的观察Narcotrend监测下右美托咪啶在语言功能区手术中唤醒麻醉的临床应用效果。方法入选需进行语言功能区手术患者40例,随机分为右美托咪啶组(试验组)20例和丙泊酚复合瑞芬太尼组(对照组)20例,试验组持续输注右美托咪啶0.5μg·kg-1·min-1,对照组持续输注丙泊酚4μg·m L-1、瑞芬太尼4.5 ng·m L-1。用Narcotrend监测2组麻醉前(T0)、切皮前(T1)、开颅时(T2)、唤醒开始(T3)、唤醒开始10 min(T4),唤醒开始15 min(T5)、唤醒结束前10 min(T6)、唤醒期结束(T7)的平均动脉压、心率及麻醉深度指数(NI)值,记录唤醒持续时间和唤醒期间配合程度、呛咳次数、躁动次数。结果 2组T0、T1、T2、T3、T4时的血压、心率差异无统计学意义(P0.05),试验组在T5、T6和T7时的平均动脉压、心率明显低于对照组(P0.05)。2组各时点NI值差异无统计学意义(P0.05)。试验组唤醒持续时间、配合程度显著高于对照组(P0.05);试验组呛咳次数和体动次数显著低于对照组(P0.05)。结论右美托咪啶用于语言功能区手术术中唤醒麻醉不降低NI值,能降低平均动脉压和心率,维持血流动力学更加稳定,不良反应发生率低。
[Abstract]:Objective to observe the clinical effect of dexmetidine in arousal anesthesia during speech functional area operation monitored by Narcotrend. Methods A total of 40 patients were randomly divided into two groups: dexmetidine group (n = 20) and propofol combined with remifentanil group (n = 20). The experimental group was continuously infused with dexmetidine 0.5 渭 g kg-1 min-1,. The control group received 4 渭 g propofol and remifentanil 4.5 ng ml -1. Narcotrend was used to monitor the mean arterial pressure, heart rate and anaesthesia depth index (NI) before anaesthesia (T0), skin incision (T1), craniotomy (T2), arousal (T3), arousal 10 min (T4), arousal 15 min (T5), and end of wake-up (T7). The duration of arousal and the degree of coordination during arousal, cough and restlessness were recorded. Results there was no significant difference in blood pressure and heart rate between the two groups (P0.05). The mean arterial pressure and heart rate in T5 T6 and T7 were significantly lower than those in the control group (P0.05). There was no significant difference in NI between the two groups at each time point (P0.05). The duration of arousal in the experimental group was significantly higher than that in the control group (P0.05), and the times of cough choking and body movement in the experimental group were significantly lower than those in the control group (P0.05). Conclusion the arousal anesthesia of dexmetidine in speech functional area surgery does not decrease the NI value, decrease the mean arterial pressure and heart rate, maintain hemodynamics more stable, and lower the incidence of adverse reactions.
【作者单位】：赣州市人民医院麻醉科;
【基金】：赣州市指导性科技计划基金资助项目(GZ2013ZSF189)
【分类号】：R614

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