中国临床药理学杂志
中國臨床藥理學雜誌
중국림상약이학잡지
The Chinese Journal of Clinical Pharmacology
2015年
19期
1916-1918
,共3页
钟宝琳%黄桂明%李以平%陈以建%李优春
鐘寶琳%黃桂明%李以平%陳以建%李優春
종보림%황계명%리이평%진이건%리우춘
Narcotrend%右美托咪啶%语言功能区%术中唤醒%麻醉
Narcotrend%右美託咪啶%語言功能區%術中喚醒%痳醉
Narcotrend%우미탁미정%어언공능구%술중환성%마취
Narcotrend%dexmedetomidine%language functional surgery%wake-up test%anesthesia
目的 观察Narcotrend监测下右美托咪啶在语言功能区手术中唤醒麻醉的临床应用效果. 方法 入选需进行语言功能区手术患者40例,随机分为右美托咪啶组(试验组) 20例和丙泊酚复合瑞芬太尼组(对照组) 20例,试验组持续输注右美托咪啶0.5 μg? kg-1? min-1 ,对照组持续输注丙泊酚4 μg? mL-1、瑞芬太尼4.5 ng? mL-1. 用Narcotrend监测2组麻醉前( T0 )、切皮前( T1 )、开颅时( T2 )、唤醒开始( T3 )、唤醒开始10 min( T4 ) ,唤醒开始15 min( T5 )、唤醒结束前10 min( T6 )、唤醒期结束( T7 )的平均动脉压、心率及麻醉深度指数( NI)值,记录唤醒持续时间和唤醒期间配合程度、呛咳次数、躁动次数.结果 2组T0、T1、T2、T3、T4时的血压、心率差异无统计学意义( P>0.05 ) ,试验组在T5、T6和T7时的平均动脉压、心率明显低于对照组( P<0.05 ). 2组各时点NI值差异无统计学意义( P >0.05 ). 试验组唤醒持续时间、配合程度显著高于对照组( P<0.05 );试验组呛咳次数和体动次数显著低于对照组( P<0.05 ). 结论 右美托咪啶用于语言功能区手术术中唤醒麻醉不降低NI值,能降低平均动脉压和心率,维持血流动力学更加稳定,不良反应发生率低.
目的 觀察Narcotrend鑑測下右美託咪啶在語言功能區手術中喚醒痳醉的臨床應用效果. 方法 入選需進行語言功能區手術患者40例,隨機分為右美託咪啶組(試驗組) 20例和丙泊酚複閤瑞芬太尼組(對照組) 20例,試驗組持續輸註右美託咪啶0.5 μg? kg-1? min-1 ,對照組持續輸註丙泊酚4 μg? mL-1、瑞芬太尼4.5 ng? mL-1. 用Narcotrend鑑測2組痳醉前( T0 )、切皮前( T1 )、開顱時( T2 )、喚醒開始( T3 )、喚醒開始10 min( T4 ) ,喚醒開始15 min( T5 )、喚醒結束前10 min( T6 )、喚醒期結束( T7 )的平均動脈壓、心率及痳醉深度指數( NI)值,記錄喚醒持續時間和喚醒期間配閤程度、嗆咳次數、躁動次數.結果 2組T0、T1、T2、T3、T4時的血壓、心率差異無統計學意義( P>0.05 ) ,試驗組在T5、T6和T7時的平均動脈壓、心率明顯低于對照組( P<0.05 ). 2組各時點NI值差異無統計學意義( P >0.05 ). 試驗組喚醒持續時間、配閤程度顯著高于對照組( P<0.05 );試驗組嗆咳次數和體動次數顯著低于對照組( P<0.05 ). 結論 右美託咪啶用于語言功能區手術術中喚醒痳醉不降低NI值,能降低平均動脈壓和心率,維持血流動力學更加穩定,不良反應髮生率低.
목적 관찰Narcotrend감측하우미탁미정재어언공능구수술중환성마취적림상응용효과. 방법 입선수진행어언공능구수술환자40례,수궤분위우미탁미정조(시험조) 20례화병박분복합서분태니조(대조조) 20례,시험조지속수주우미탁미정0.5 μg? kg-1? min-1 ,대조조지속수주병박분4 μg? mL-1、서분태니4.5 ng? mL-1. 용Narcotrend감측2조마취전( T0 )、절피전( T1 )、개로시( T2 )、환성개시( T3 )、환성개시10 min( T4 ) ,환성개시15 min( T5 )、환성결속전10 min( T6 )、환성기결속( T7 )적평균동맥압、심솔급마취심도지수( NI)치,기록환성지속시간화환성기간배합정도、창해차수、조동차수.결과 2조T0、T1、T2、T3、T4시적혈압、심솔차이무통계학의의( P>0.05 ) ,시험조재T5、T6화T7시적평균동맥압、심솔명현저우대조조( P<0.05 ). 2조각시점NI치차이무통계학의의( P >0.05 ). 시험조환성지속시간、배합정도현저고우대조조( P<0.05 );시험조창해차수화체동차수현저저우대조조( P<0.05 ). 결론 우미탁미정용우어언공능구수술술중환성마취불강저NI치,능강저평균동맥압화심솔,유지혈류동역학경가은정,불량반응발생솔저.
Objective To investigate the value of dexmedetomidine in intraoperative wake -up test during language functional surgery with nar-cotrend monitor.Methods Forty patients needing language functional surgery were randomly divided into treatment group and control group , which were pumped with dexmedetomidine (0.5 μg? kg -1? min-1 ) and propofol(4 μg? mL-1 ) combined with remifentanyl (4.5 ng? mL -1 ), respectively.Narcotrend scale, heart rate ( HR) and mean arterial pre-ssure(MAP) were recorded at the beginning of anesthesia (T0), before cut skin ( T1 ) , when the craniotomy ( T2 ) , waking up ( T3 ) , at every 5 min before 10 min of the beginning of waking up ( T4 and T5 ) , 10 min before the end of waking up ( T6 ) , abd the end of wakeing up ( T7 ) . Arousing time and recovery quality including the degree of cooperateing , bucking and agitation were also recorded .Results There was no statisti-cally significant difference of MAP and HR between the two groups at T 0 , T1, T2, T3 and T4(P>0.05).MAP, HR of treatment group at T5,T6 and T7 were lower than those of control group (P<0.05).There was no difference of Narcotrend index(NI) between the two groups(P>0.05).Arousing time and the degree of cooperateing of treatment group were significantly higher than that of control group ( P<0.05 ) .Bucking and agitation of treatment group were significantly lower than those of control group ( P<0.05 ) . Conclusion Dexmedetomidine used in language function surgery does not reduce the NI value , but can reduce the MAP and HR, maintain hemodynamic stability and reduce adverse reactions .
