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。%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 .
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