右美托咪定对颅脑手术全麻苏醒期应激反应的影响

摘要

Objective To observe the effect of dexmedetomidine on stress response during recovery period after general anesthesia in neurosurgical patients. Methods Forty patients with ASA Ⅰor Ⅱ undergoing elective brain tumors surgeries were randomized into dexmedetomidine group (group D) and control group (group C) with 20 cases each. Patients in group D received continuously infusion of exmedetomidine 1 μg/kg 30 min before the end of surgery for 15 min, while group C was without dexmedetomidine infusion. The MAP, HR and Sp()2 were recorded at 30 min before the end of surgery (T1 ). Immediate end of surgery (T2) and extubation (T3), and blood glucose, renal activity and norepinephrine levels were detected at T1 -T3 in both groups. Results Compared with group C, MAP and HR in group D were significantly lower at T2 and T3 (P<0. 01); the blood glucose and renal activity in group D decreased (P<0. 05); the norepinephrine activity in group D was significantly lower at T3 (P<0. 01). Conclusion Dexmedetomidine can inhibit stress response during the recovery from general anesthesia in neurosurgical patients, and it is beneficial to hemodynamic stability.%目的 观察右美托咪定对颅脑手术全麻苏醒期机体应激反应的影响.方法 40例ASA Ⅰ或Ⅱ级颅内肿瘤行择期手术患者随机均分为右美托咪定组(D组)和对照组(C组).D组手术结束前30 min微量泵静脉输注右美托咪定1μg/kg,输注时间为15 min;C组不输注右美托咪定.记录两组手术结束前30 min(T1)、手术结束时(T2)及气管导管拔管时(T3) MAP、HR和SpO2.留取静脉血检测T1～T3时血糖、肾素活性及去甲肾上腺素水平.结果 与C组比较,T2、T3时D组MAP明显降低,HR明显减慢(P＜0.01)；T2、T3时血糖和肾素活性降低(P＜0.05)；T3时去甲肾上腺素明显降低(P＜0.01).结论 右美托咪定能明显抑制颅脑手术患者全麻苏醒期的应激反应,有利于血流动力学的稳定.