右美托咪定对颅脑创伤急救患者麻醉诱导期血流动力学和脑电双频指数的影响

发布时间：2019-06-10 21:11

【摘要】：目的评价右美托咪定对颅脑创伤急救患者麻醉诱导期血流动力学和脑电双频指数的影响。方法入选80例颅脑创伤患者分成试验组和对照组,各40例。试验组静脉注射右美托咪定1μg·kg-1,对照组静脉注射等量的生理盐水。观察2组患者在右美托咪定或生理盐水前(T0)、麻醉诱导前(T1)、气管插管前(T2)、气管插管完成即刻(T3)、完成1 min(T4)、完成3 min(T5)、完成5 min(T6)的平均动脉压、心率、脑电双频指数变化及不良反应发生情况。结果对照组T3~T5时的平均动脉压与T2时相比显著升高(P0.05),T3、T4时的心率与T2时相比显著升高(P0.05)。试验组的平均动脉压和心率在T3、T4时明显低于对照组(P0.05);试验组T1的脑电双频指数显著低于T0(P0.05)。2组患者T2~T6的脑电双频指数明显低于T0与T1(P0.05);对照组T4、T5的脑电双频指数高于T2(P0.05)。试验组在T1、T4、T5时的脑电双频指数明显低于对照组(P0.05)。试验组不良反应发生率为7.5%,对照组无明显不良反应发生,差异无统计学意义(P0.05)。结论对于颅脑创伤患者麻醉诱导前使用右美托咪定能对患者产生明显镇静作用,可以有效抑制气管插管后3 min患者脑电双频指数的反应性的升高,同时患者的血流动力学更平稳。
[Abstract]:Objective to evaluate the effects of dexmetomide on hemodynamics and bispectral index during anesthesia induction in patients with craniocerebral trauma. Methods 80 patients with craniocerebral trauma were divided into experimental group (n = 40) and control group (n = 40). The experimental group was intravenously injected with right metomedine 1 渭 g kg-1, and the control group was injected with the same amount of saline intravenously. The patients in the two groups were observed before right metomedine or saline (T0), before anesthesia induction (T1), before endotracheal intubation (T2), immediately after endotracheal intubation (T3), 1 min (T4) and 3 min (T5). The mean arterial pressure, heart rate, bispectral index and adverse reactions of 5 min (T6) were completed. Results in the control group, the mean arterial pressure at T3~T5 was significantly higher than that at T2 (P 0.05), and the heart rate at T3 and T 4 was significantly higher than that at T2 (P 0.05). The mean arterial pressure and heart rate in the experimental group were significantly lower than those in the control group (P 0.05), and the bispectral index of EEG in the experimental group T1 was significantly lower than that in the control group (P 0.05). The bispectral index of T2~T6 in the two groups was significantly lower than that in the control group (P 0.05). The bispectral index of EEG in control group T 4 and T 5 was higher than that in T 2 (P 0.05). The bispectral index of EEG in the experimental group at T 1, T 4 and T 5 was significantly lower than that in the control group (P 0.05). The incidence of adverse reactions was 7.5% in the experimental group and no significant difference in the control group (P 0.05). Conclusion dexmetomide can have obvious sedation effect on patients with craniocerebral trauma before anesthesia induction, and can effectively inhibit the increase of EEG bispectral index responsiveness in patients with 3 min after endotracheal intubation. At the same time, the hemodynamics of the patients was more stable.
【作者单位】：新疆医科大学第一附属医院麻醉科;
【基金】：新疆维吾尔自治区自然科学基金资助项目(2011211B33)
【分类号】：R614

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