CAJ | 학술논문

目的：观察右美托咪定用于脑语言功能区全麻术中唤醒对清醒质量的影响。方法 ASAⅠ~Ⅱ级累及语言功能区全麻开颅手术患者20例,随机分为两组,其中右美托咪定组( D组)10例,对照组( C组)10例,开颅前两组均以丙泊酚+瑞芬太尼+肌松药维持麻醉,颅骨瓣打开后,D组改为右美托咪定0.5μg/(kg·h)替代,唤醒前及唤醒期减至0.1μg/(kg·h)维持。 C组唤醒前及唤醒期改为丙泊酚30μg/(kg·min)维持。分别观察两组的清醒时间、清醒期平均动脉压( MAP)、心率( HR)、血氧饱和度( SpO2)、血气变化、清醒质量(包括意识、语言、指令、颅内压评分)以及不良反应。结果清醒时间D组明显短于C组,清醒期MAP和心率D组较C组更稳定,清醒质量D组明显优于C组,不良反应D组明显少于C组。结论右美托咪定独特的镇静类型,对呼吸几乎无抑制,非常适合术中唤醒用药,能提高全麻术中唤醒期的清醒质量,值得临床进一步应用研究。
목적：관찰우미탁미정용우뇌어언공능구전마술중환성대청성질량적영향。방법 ASAⅠ~Ⅱ급루급어언공능구전마개로수술환자20례,수궤분위량조,기중우미탁미정조( D조)10례,대조조( C조)10례,개로전량조균이병박분+서분태니+기송약유지마취,로골판타개후,D조개위우미탁미정0.5μg/(kg·h)체대,환성전급환성기감지0.1μg/(kg·h)유지。 C조환성전급환성기개위병박분30μg/(kg·min)유지。분별관찰량조적청성시간、청성기평균동맥압( MAP)、심솔( HR)、혈양포화도( SpO2)、혈기변화、청성질량(포괄의식、어언、지령、로내압평분)이급불량반응。결과청성시간D조명현단우C조,청성기MAP화심솔D조교C조경은정,청성질량D조명현우우C조,불량반응D조명현소우C조。결론우미탁미정독특적진정류형,대호흡궤호무억제,비상괄합술중환성용약,능제고전마술중환성기적청성질량,치득림상진일보응용연구。
Objective To observe the effects of the α2 adrenaline receptor agonists-Dexmedetomidine ( DEX) used in the wake-up surgery of brain function language areas. Method There were 20 patients of ASAⅠ~Ⅱthe brain function language area surgery with general anesthesia. Randomly divided into two groups, 10 cases of the Dexmedetomidine group ( group D) and 10 cases of the control group ( group C) , the two groups are the craniotomy with propofol add remifentanyl add muscle relaxant maintain anesthesia, when skull flap opens, two groups of stopping the anesthetic, group D to the right supporting the Dexmedetomidine 0. 5μg/(kg·h), replacement, to wake up and before awaken-ing period to 0. 1μg/(kg·h). The propofol of the group C were less to 30μg/(kg·min) before waking up. Respec-tively observe the two groups of the time of awake, and MAP, HR, SpO2 during awake period, blood gas analysis, clear quality ( including consciousness, language, instructions, intracranial pressure rating) and adverse reactions. Result Waking time of the group D was significantly shorter than the group C, awake period MAP and heart rate of the group D were more stable than group C, awake quality of the group D was obviously better than the group C, adverse reaction of the group D was significantly less than group C. Conclusion The sedation type of the Dexmedetomidine has no effect on breathing, is very suitable for intraoperative awaken medication, can improve the quality of intraoperative awakening period awake during anesthesia, is worthy of clinical application research further.