术前口服可乐定对脊柱手术患者全麻苏醒的影响

目的:观察脊柱手术患者术前口服可乐定对全麻苏醒的影响。方法:将64例ASAⅠ-Ⅱ级,18~60岁,择期行椎管减压、脊柱融合手术的患者随机分为术前口服可乐定组(200μg)和安慰剂组(维生素C 600 mg)。麻醉诱导采用芬太尼2μg/kg、异丙酚1~2 mg/kg及维库溴铵0.1 mg/kg。气管插管后机械通气,调整吸入异氟烷浓度维持BIS 40~50,间断给予维库溴铵维持肌松。调整呼吸参数维持ETCO235~40 mm Hg。记录患者一般资料,芬太尼、异丙酚用量、麻醉时间、拔管时间、低血压或高血压发生率。结果:可乐定组患者芬太尼用量少于安慰剂组(2.11±0.87 vs 3.68±0.93,P<0.05),拔管时间早于安慰剂组(9.88±6.12 vs 13.62±9.74,P<0.05),异丙酚用量、低血压及心动过缓发生率组之间没有统计学意义(P>0.05)。结论:脊柱手术的患者,术前给于可乐定能减轻麻醉所需麻醉药的用量,加快麻醉后复苏,并且不增加低血压和心动过缓的发生率。

The effects of oral clonidine for premedication of anesthetic recovery on the spinal operation patients

Objective:To observe the effects of oral clonidine premedication on the general anesthesia and recovery in patients undergoing spinal surgery. Methods:Sixty-four ASA levelⅠ-Ⅱ patients (18-60 years old) undergoing major spine surgery were ran-domly allocated to two groups. One group received oral clonidine (200 μg) and the other received placebo (Vitamin C 600 mg) for premedication. Standard anesthesia protocols were followed for induction Fentanyl 2 μg/kg,Propofol 1~2 mg/kg and Vecuronium Bro-mide 0. 1 mg/kg. The mechanical ventilation was performed after the tracheal intubation. And the concentration of isoflurance was adjus-ted and maintained at the level of BIS 40~50. The Vecuronium Bromide was given inconsistently in order to keep the muscular relaxa-tion. The reference data of breathing is adjusted at the level of ETCO2 35~40 mmHg. Heart rate,blood pressure,and end-tidal concen-trations of isoflurane were monitored. Hypotensive episodes were treated with bolus doses of ephedrine or phenylephrine. Results:The demographic data,duration of anesthesia,propofol requirement were not significant between the two groups. The total dose of fentanyl (2. 11 ± 0. 87 vs. 3. 68 ± 0. 93) and the recovery time (9. 88 ± 6. 12vs. 13. 62 ± 9. 74) were decreased in clonidine group. There was no statistical difference in the change of hemodynamic parameters,the incidence of hypotension or bradycardia between the two groups. Conclusion:Clonidine for premedication can reduce the requirement of opoids,facilitate the recovery from inhaled isoflurane anesthe-sia,and does not increase the incidence of hypotension or bradycardia.