右美托咪定用于神经外科术中唤醒的临床效果

目的观察右美托咪定用于神经外科手术中的术中唤醒效果。方法40例神经外科患者随机分为两组，每组20例。瑞芬太尼一丙泊酚组（P组）：麻醉诱导及麻醉维持为靶控输注瑞芬太尼和丙泊酚。右美托咪定一瑞芬太尼一丙泊酚组（D组）：整个麻醉过程均泵注右美托咪定至手术结束，其余麻醉及维持用药同P组。分别观察两组患者血流动力学变化、唤醒时间、唤醒质量、麻醉深度以及术中、术后的不良反应或并发症。结果两组患者均顺利实施术中唤醒，唤醒期呼之睁眼时间和指令运动时间D组均明显短于P组（P〈0．05）；苏醒质量评级D组明显高于P组（P〈0．05）；唤醒即刻两组MAP、HR比较P组均高于D组（P〈0．05）。结论右美托咪定用于神经外科术中唤醒麻醉效果好，苏醒质量高，血流动力学平稳，安全、有效，值得临床推广。

Dexmedetomidine for wake-up test in neurosurgery operation

Objective To observe the effect of dexmedetomidine on the wake-up test in neurosurgery operation. Methods 40 neurosurgery patients were randomly divided into two groups, 20 for each group： Remifentanil combined with propofol group （group P）： anesthesia induction and anesthesia maintenance used target-controlled infusion （TCI） of remifentanil and propofol; dexmedetomidine combined with remifentanil and propofol group （group D）： target-controlledly infused dexmedetomidine through the whole operation, the rest methods and maintaining drugs were the same as group P. Observed the hemodynamic changes, the duration and the quality of waking, the depth of anesthesia, the adverse effects and the complications during and after the op- eration. Results Wake-up test was implemented successfully for both groups. The durations for opening eyes and moving instructions during waking-up period were significantly shorter in group D than in group P （P 〈 0.05 ）. The score of waking quality was significantly higher in group D than in group P（P〈 0.05）. MAP and HR at the moment of waking up were higher in group P than in group D （P 〈 0.05 ）. Conclusions Dexmedetomi- dine for wake-up test in neurosurgery operation has good effect, high waking quality, stable haemodynamics, and safety. It is worth clinically generalizing.