CAJ | 학술논문

目的：评价右美托咪定对丙泊酚-瑞芬太尼麻醉下脊柱侧弯矫形术术中唤醒效果的影响。方法择期行脊柱侧弯矫形术患者36例，分为右美托咪定组（D组）和生理盐水组（C组），分别在麻醉诱导前给予1μg/kg右美托咪定和等量生理盐水，10 min内输完。术中D组持续泵入右美托咪定0．2μg · kg -1· h-1，C组泵入生理盐水。每组18例。观察麻醉诱导前10 min（T1）、麻醉诱导后3 min（T2）、停药即刻（T3）、唤醒即刻（T4）以及加深麻醉后5 min（T5）的平均动脉压（MAP）、心率（HR）。记录两组血流动力学变化情况、苏醒时间、唤醒成功率、唤醒期间的躁动情况及唤醒期间血管活性药的用量。结果两组唤醒成功率相似， D组唤醒时间稍长但无统计学意义（P＞0．05），躁动发生率及唤醒期间血管活性药的用量D组显著低于C组（P＜0．05）。结论右美托咪定辅助丙泊酚-瑞芬太尼麻醉能有效实施术中唤醒，唤醒期间血流动力学更平稳，不良事件发生率更低。
목적：평개우미탁미정대병박분-서분태니마취하척주측만교형술술중환성효과적영향。방법택기행척주측만교형술환자36례，분위우미탁미정조（D조）화생리염수조（C조），분별재마취유도전급여1μg/kg우미탁미정화등량생리염수，10 min내수완。술중D조지속빙입우미탁미정0．2μg · kg -1· h-1，C조빙입생리염수。매조18례。관찰마취유도전10 min（T1）、마취유도후3 min（T2）、정약즉각（T3）、환성즉각（T4）이급가심마취후5 min（T5）적평균동맥압（MAP）、심솔（HR）。기록량조혈류동역학변화정황、소성시간、환성성공솔、환성기간적조동정황급환성기간혈관활성약적용량。결과량조환성성공솔상사， D조환성시간초장단무통계학의의（P＞0．05），조동발생솔급환성기간혈관활성약적용량D조현저저우C조（P＜0．05）。결론우미탁미정보조병박분-서분태니마취능유효실시술중환성，환성기간혈류동역학경평은，불량사건발생솔경저。
Objective To investigate the effect of dexmedetomidine on awareness during intraoperative Wake-up tests in patients undergoing spinal surgery under propofol-remifentanil anesthesia .Methods 36 patients ,requiring intraoperative arousal test during posterior spinal surgery were randomly divided into the group D (DEX ,n= 18) and C (NS ,n= 18) .DEX 1 μg/kg followed by 0 .2 μg · kg -1 · h-1 and equal volume NS were infused respectively 10 min before anesthesia induction and maintenance of anesthe-sia in two groups .Hemodynamic parameters were monitored 5 min(T1) before anesthesia induction ,3 min(T2)after anesthesia in-duction ,at the beginning of wake-up test(T3) ,at the end of the test(T4) and 5 min(T5) after deepen anesthesia respectively . Meanwhile the wake-up time ,success rate of arousal ,incidence agitation and the dosage of nitroglycerin during wake-up were also recorded .Results Successive rate of arousal awakening time between two group had no statistically significance (P>0 .05) .less in-cidence of agitation was found in group D compared with group C ,the dosage of nitroglycerin used during wake-up in group D was less than that in group C(P<0 .05) .Conclusion Dexmedetomidine auxiliary propofol remifentanil anesthesia can effectively implement intraoperative wake up ,during the awakening the hemodynamic was more smoothly ,and it has lower incidence of adverse events .