摘要
目的探讨脑肿瘤患者术中应用右旋美托咪啶对芬太尼剂量及血流动力学的影响及其安全性。方法选择欲行脑肿瘤切除术的患者共62例，随机分为观察组和对照组各31例，观察组应用右旋美托咪啶0．5μg/kg，30min后1．0μg·kg^-1·h^-1泵注。对照组予0．9％氯化钠注射液以同样的方式同步输注。记录并比较两组患者在术中所用的麻醉药的剂量以及血流动力学的改变。结果观察组患者在进行麻醉诱导以及其后的整个手术过程中的平均心率和平均动脉压均低于基础值（均P〈0．05），对照组患者在手术进行60min后其平均心率和平均动脉压始低于基础值（均P〈0．05），观察组全程的平均心率和平均动脉压均低于对照组（均P〈0．05）。观察组应用芬太尼的剂量低于对照组[分别为（427．5±61．2）、（704．3±84．1）μg]（t=95．721，P〈0．05），异氟烷的呼气末浓度也低于对照组（P〈0．05）。结论右旋美托咪啶应用于脑肿瘤术中稳定脑血流动力学的效果确切，安全性好，可显著减少术中所需的麻醉药及麻醉辅助剂的剂量。
Objective To study the effect and safety of dexmedetomidine on the intraoperative fentanyl requirements and cerebral hemodynamics in patients undergoing intracranial tumor surgery. Methods 62 patients scheduled for intracranial tumor surgery were selected and divided into observe group （31 cases） and control group （31 cases）. Dexmedetomidine （0.5 μg/kg） was loaded in observe group, and followed by a continuous infusion of a rate of 1.0μg · kg^-1 ·h^-1 half an hour later. Saline was infused in the same time and the same way in control group. Dose of anesthetic and change of cerebral hemodynamics were recorded and compared. Results The mean heart rate and mean arterial blood pressure were lower in observe group than the underlying value when inducing anesthesia and dur- ing the operation（ all P 〈 0.05 ） ,while that happened after operation starting 60 minutes later in control group（ all P 〈 0.05）. The mean heart rate and mean arterial blood pressure were lower in observe group those that in control group （all P 〈0.05 ）. Dose of fentanyl and end-tidal sevoflurane concentration were lower in observe group（ all P 〈0.05 ）. Conclusion Dexmedetomidine used for cerebral hemodynamics stabiliby in intracranial tumor surgery has obvious curative effect and good safety. And it could decrease the dose of anesthetics and anesthesia adjuvant.
出处
《中国基层医药》
CAS
2013年第3期353-355,共3页
Chinese Journal of Primary Medicine and Pharmacy
