右美托咪定-丙泊酚-舒芬太尼麻醉用于脊柱侧弯矫形术的临床观察

目的 观察右美托咪定辅助靶控丙泊酚-舒芬太尼麻醉用于脊柱侧弯矫形术的安全性和有效性.方法 择期行脊柱侧弯矫形术患者40例,按随机数字表法分为右美托咪定组（D组）和生理盐水组（C组）,每组20例,分别在麻醉诱导前给予0.8 μg/kg右美托咪定和等量生理盐水,10 min输完.术中D组持续泵入右美托咪定0.2μg/（kg·h）,C组输注等容量生理盐水.观察麻醉诱导前10 min（T1）、麻醉诱导后3 min（T2）、气管插管后1 min（T3）、停药（T4）、唤醒即刻（T5）、加深麻醉后6 min（T6）的收缩压（SBP）、舒张压（DBP）、心率（HR）.记录两组血液动力学、唤醒时间、唤醒成功率、唤醒期间的躁动情况及唤醒期间的出血量,记录有无术中知晓.结果 两组唤醒成功率比较差异无统计学意义（P＞0.05）,D组较C组血液动力学稳定（P＜0.05）,D组躁动的发生率及唤醒期间的出血量显著少于C组（P＜0.05）.结论 右美托咪定辅助靶控丙泊酚-舒芬太尼麻醉能有效实施术中唤醒,有助于减少唤醒期间的出血量及躁动的发生,使术中血流动力学更平稳.

Effect of dexmedetomidine on hemodynamics and awareness in patients undergoing scoliosis surgery under propofol sufentanil anesthesia

Objective To investigate effect of dexmedetomidine on safety,validity and superiority in patients undergoing scoliosis surgery under propofol sufentanil anesthesia.Methods Forty patients undcrgoing elective posterior scoliosis surgery were randomly divided into groups D and C （n =10 each）.Dexmedetomidine 0.8 μg/kg followed by 0.2 μg/（kg · h） and equal volume were infused at the 10 min before anesthesia induction in two groups,respectively.Hemodynamic parameters were observed at the 10 min before anesthesia induction （T1）,3 min （T2） after anesthesia induction,1 min （T3） after intubation,at the beginning of wake-up test （T4）,at the end of the test （T5）,and 6 min （T6） after deepen anesthesia,respectively.Meanwhile the wake-up time,hemodynamic parameters,success rate of arousal,incidence agitation,and the bleeding volume during the test were also recorded.Results Successive rate of arousal awakening time between two groups had no statistical significance （P ＞ 0.05）.Less incidence of agitation was found in group D compared to group C （P ＜ 0.05）.The bleeding volume during the test was significantly less in group D （P ＜ 0.05）.The hemodynamics was more smoothly during the operation in group D compared to group C （P ＜ 0.05）.Conclusions Dexmedetomidine auxiliary propofol and sufentanil anesthesia can effectively implement intraoperative wake-up,reduce the amount of bleeding,and the incidence of agitation during the wake-up.The hemodynamics was more smoothly.