摘要
目的观察右美托咪定对靶控输注丙泊酚复合瑞芬太尼在脑胶质瘤切除术中唤醒麻醉的应用效果。方法选取2018年1月~2023年3月我院收治的40例脑胶质瘤切除手术患者,按照随机数字表法分为两组,每组20例。分别为右美托咪定组与对照组。两组均采用丙泊酚复合瑞芬太尼维持麻醉,其中对照组静脉泵注生理盐水,右美托咪定组静脉泵注右美托咪定,比较两组术中唤醒麻醉效果:不良反应,麻醉唤醒时脑电双频指数,苏醒时间和拔管时间,数字评价量表(numerical rating scale,NRS),血流动力学(平均动脉压和心率),动脉血气指标(动脉血二氧化碳分压和动脉氧分压)。结果右美托咪定组术中麻醉唤醒时的动脉血二氧化碳分压(arterial carbon dioxide tension,PaCO_(2))、血流动力学指标与麻醉唤醒不良反应发生率均低于对照组,且麻醉质量、脑电双频指数(bispectral index,BIS)与动脉氧分压(arterial oxygen tension,PaO_(2))高于对照组,麻醉结束后的苏醒质量也高于对照组,差异有统计学意义(P<0.05)。结论在脑胶质瘤切除术中选用右美托咪定靶控输注丙泊酚复合瑞芬太尼麻醉能够有效提高术中唤醒麻醉效果,改善麻醉质量和苏醒质量,并减少唤醒期不良反应的发生,临床应用价值较高。
Objective To investigate the effect of dexmedetomidine on awake anesthesia during controlled infusion of propofol combined with remifentanil in cerebral glioma resection.Methods Forty patients who underwent glioma resection in our hospital from January 2018 to March 2023 were randomly divided into two groups:dexmedetomidine group and control group,20 cases in each group.The control group received saline whereas the dexmedetomidine group received dexmedetomidine intravenously.Anesthesia was maintained with propofol and remifentanil.The effects of awake anesthesia during operation were compared between the two groups,such as adverse reactions,bispectral index,recovery time and extubation time,numerical rating scale(NRS),hemodynamics indexes including mean arterial pressure(MAP)and heart rate(HR),arterial blood gas indexes including arterial carbon dioxide tension(PaCO_(2))and arterial oxygen tension(PaO_(2)).Results The PaCO_(2)hemodynamic indexes and the incidence of adverse reactions during awake anesthesia in the dexmedetomidine group were significantly lower compared with the placebo group(P<0.05),however the quality of anesthesia,bispectral index(BIS)and PaO_(2)in the dexmedetomidine group were higher compared with the control group(P<0.05).The quality of awakening after anesthesia was also higher than that in the control group(P<0.05).Conclusion The use of dexmedetomidine controlled infusion combined with propofol and remifentanil anesthesia during glioma resection can effectively improve the effect of intraoperative awake anesthesia,improve the quality of anesthesia and recovery,and reduce the occurrence of adverse reactions during awake period.It has high clinical value.
作者
高彩燕
韩大勇
聂焱
GAO Cai-yan;HAN Da-yong;NIE Yan(Department of Anesthesiology,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Department of Neurosurgery,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《哈尔滨医科大学学报》
CAS
2023年第4期389-393,共5页
Journal of Harbin Medical University
基金
哈尔滨医科大学附属第一医院科研创新基金(2021M05)
