目的观察预防性使用右美托咪定(dexmedetomidine, DEX)对幕上脑肿瘤切除术患者气管插管时血流动力学的影响。方法选取首都医科大学宣武医院择期行幕上脑肿瘤切除术的患者68例,随机分为对照组(C组),右美托咪定预处理组(DEX组)。DEX组患...目的观察预防性使用右美托咪定(dexmedetomidine, DEX)对幕上脑肿瘤切除术患者气管插管时血流动力学的影响。方法选取首都医科大学宣武医院择期行幕上脑肿瘤切除术的患者68例,随机分为对照组(C组),右美托咪定预处理组(DEX组)。DEX组患者在麻醉开始前持续外周静脉匀速泵注0.5μg/kg右美托咪定15 min,C组泵注等量生理盐水。记录患者入室时(T_0)、右美托咪定泵注结束时(T_1)、插管即刻(T_2)、插管后5 min(T_3)及插管后10 min(T_4)的MAP、HR,术中出入量、麻醉时间、手术时间、麻醉恢复室(postanesthesia care unit, PACU)停留时间。结果DEX组患者在T_2、T_3及T_4时的MAP及HR均明显低于对照组,差异有统计学意义(P <0.05),而在T_0、T_1时差异无统计学意义(P>0.05)。结论预防性使用DEX有助于维持幕上肿瘤手术患者气管插管时期血流动力学的稳定,优化传统的麻醉方案。展开更多
Objective To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. Methods Eighty cases of sup...Objective To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. Methods Eighty cases of supratentorial tumor resection were randomly divided into a group A and a group S, 40 cases in each group. All the patients were anesthetized with 2% Sevoflurane. The patients in group A received eleetroacupuneture at Hegu （合谷 LI 4） and Waiguan （外关 TE 5）, Jinmen （金门 BL 63） and Taichong （太冲 LR 3）, Zusanli （足三里 ST 36） and Qiuxtu（丘墟 GB 40） from anesthesia beginning to the end of operation, and in group S without electroacupuncture. tidal Sevoflurane concentration, minimum alveolar concentration （MAC）, bispectral index （BIS） and the information during anesthesia recovery stage were recorded, respectively. Results The end-tidal concentration and MAC of Sevoflurane in group A at all times were significant lower than those in group S （P〈0.05, P〈0.01） with a Sevoflurane saving of 9.62% on average. The BIS in group A during a few phases were higher than that in group S （all P〈0.05）. During anesthesia recovery stage, the time of each phase in group A was significantly shorter than that in group S （all P〈0.01）. No dysphoria and one case with nausea and vomiting were shown in group A, but in group S, 2 patients had dysphoria and 3 patients had nausea and vomiting. Conclusion Electroacupuncture combined with Sevoflurane anesthesia can decrease the dosage of Sevoflurane, shorten the recovery time of anesthesia and improve the quality of anesthesia recovery of the patients undergoing resection of supratentorial tumor.展开更多
文摘目的观察预防性使用右美托咪定(dexmedetomidine, DEX)对幕上脑肿瘤切除术患者气管插管时血流动力学的影响。方法选取首都医科大学宣武医院择期行幕上脑肿瘤切除术的患者68例,随机分为对照组(C组),右美托咪定预处理组(DEX组)。DEX组患者在麻醉开始前持续外周静脉匀速泵注0.5μg/kg右美托咪定15 min,C组泵注等量生理盐水。记录患者入室时(T_0)、右美托咪定泵注结束时(T_1)、插管即刻(T_2)、插管后5 min(T_3)及插管后10 min(T_4)的MAP、HR,术中出入量、麻醉时间、手术时间、麻醉恢复室(postanesthesia care unit, PACU)停留时间。结果DEX组患者在T_2、T_3及T_4时的MAP及HR均明显低于对照组,差异有统计学意义(P <0.05),而在T_0、T_1时差异无统计学意义(P>0.05)。结论预防性使用DEX有助于维持幕上肿瘤手术患者气管插管时期血流动力学的稳定,优化传统的麻醉方案。
基金Supported by the National Key Basic Research Program (973 Program): 2007 CB 512503
文摘Objective To observe the supplementary analgesic effect of electroacupuncture and its influence on the maintenance of anesthesia and the speed of recovery of patients undergoing craniotomy. Methods Eighty cases of supratentorial tumor resection were randomly divided into a group A and a group S, 40 cases in each group. All the patients were anesthetized with 2% Sevoflurane. The patients in group A received eleetroacupuneture at Hegu （合谷 LI 4） and Waiguan （外关 TE 5）, Jinmen （金门 BL 63） and Taichong （太冲 LR 3）, Zusanli （足三里 ST 36） and Qiuxtu（丘墟 GB 40） from anesthesia beginning to the end of operation, and in group S without electroacupuncture. tidal Sevoflurane concentration, minimum alveolar concentration （MAC）, bispectral index （BIS） and the information during anesthesia recovery stage were recorded, respectively. Results The end-tidal concentration and MAC of Sevoflurane in group A at all times were significant lower than those in group S （P〈0.05, P〈0.01） with a Sevoflurane saving of 9.62% on average. The BIS in group A during a few phases were higher than that in group S （all P〈0.05）. During anesthesia recovery stage, the time of each phase in group A was significantly shorter than that in group S （all P〈0.01）. No dysphoria and one case with nausea and vomiting were shown in group A, but in group S, 2 patients had dysphoria and 3 patients had nausea and vomiting. Conclusion Electroacupuncture combined with Sevoflurane anesthesia can decrease the dosage of Sevoflurane, shorten the recovery time of anesthesia and improve the quality of anesthesia recovery of the patients undergoing resection of supratentorial tumor.
