[1]刘书伟　吴建珩　武跃辉　王　振.右美托咪定对脑动脉瘤夹闭术中气管导管插、拔管期心血管反应及血流动力学的影响[J].中国临床神经外科杂志,2017,(06):400-402.[doi:10.13798/j.issn.1009-153X.2017.06.011]
　LIU Shu-wei,WU Jian-heng,WU Yue-hui,et al.Effect of dexmedetomidine and propofol combined with remifentanil on patients with cerebral aneurysms undergoing clipping[J].,2017,(06):400-402.[doi:10.13798/j.issn.1009-153X.2017.06.011]
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右美托咪定对脑动脉瘤夹闭术中气管导管插、拔管期心血管反应及血流动力学的影响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年06期
页码:
400-402
栏目:
论著
出版日期:
2017-06-25

文章信息/Info

Title:
Effect of dexmedetomidine and propofol combined with remifentanil on patients with cerebral aneurysms undergoing clipping
文章编号:
1009-153X（2017）06-0400-03
作者:
刘书伟　吴建珩　武跃辉　王　振
450052 郑州，郑州大学第五附属医院麻醉科（刘书伟），神经外二科（吴建珩、武跃辉、王　振）
Author(s):
LIU Shu-wei1;  WU Jian-heng2;  WU Yue-hui2;  WANG Zhen2.
1. Department of Anesthesiology, The Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China;
2. Department of Neurosurgery, The Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
关键词:
脑动脉瘤; 夹闭术; 右美托咪定; 丙泊酚; 瑞芬太尼; 麻醉效果
Keywords:
Cerebral aneurysm;  Anesthesia;  Dexmedetomidine;  Propofol;  Remifentanil;  Clipping
分类号:
R 743.9; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.06.011
文献标志码:
A
摘要:
目的 探讨右美托咪定对脑动脉瘤夹闭术中气管导管插、拔管期心血管反应及血流动力学的影响。方法 2014年12月至2016年10月手术夹闭脑动脉瘤66例，根据麻醉方法分为观察组和对照组，各33例。两组均采用瑞芬太尼、丙泊酚及维库溴铵实施麻醉诱导及维持，观察组在麻醉诱导前采用右美托咪定，对照组采用0.9%氯化钠注射液。结果 观察组维库溴铵、瑞芬太尼用量与对照组无明显差异（P>0.05）；与对照组比，观察组苏醒时间明显延长（P<0.05），丙泊酚用量明显减少（P<0.05）。气管导管插管前，两组心率（HR）、平均动脉压（MAP）无明显差异（P>0.05）；气管导管插管后、拔管前、拔管后，观察组HR、MAP均明显低于对照组（P<0.05）。观察组术中高血压（6.06%，2/33）、心动过速（0%）等发生率均明显低于对照组[分别为27.27%（9/33）、21.21%（7/33）；P<0.05]；麻醉恢复期，观察组高血压（9.09%，3/33）、心动过速（9.09%，3/33）、呕吐（3.03%，1/33）、烦躁（6.06%，2/33）等发生率均明显低于对照组[分别为33.33%（11/33）、36.36%（12/33）、24.24%（8/33）、30.30%（10/33）；P<0.05]。结论 右美托咪定可抑制脑动脉瘤夹闭术中气管导管插、拔管期心血管反应，减少丙泊酚用量，提高麻醉效果。
Abstract:
Objective To explore the effect of dexmedetomidine and propofol combined with remifentanil on the patients with cerebral aneurysms undergoing clipping. Methods Sixty-six patients with cerebral aneurysms treated in our hospital from December, 2014 to October, 2016 were randomly divided into two groups of 33 ones each, i.e. control group, in which 33 patients received the venous injection of 0.9% sodium chloride before the induction of anesthesia with remifentanil and propofol, and observed group, in which 33 patients received the venous infusion of dexmedetomidine before the induction of anesthesia with remifentanil and propofol. Anesthetic drug dosage and recovery time, and hemodynamics changes at the different time and the adverse reactions incidence during the surgery were observed and compared between the two groups. Results There was no significant difference in the amount of used rocuronium and remifentanil between both groups (P>0.05). The recovery time from anesthesia was significantly longer in the observed group than that of the control group (P<0.05). The dosage of used propofol was significantly less in the observed group than that of the control group (P<0.05). The heart rate and mean arterious pressure were significantly lower in the observed group than those in the control group after intubation, before and after extubation (P<0.05). The rates of occurrences of intraoperative hypertension and tachycardia, and vomiting and irritability during recovery from anesthesia were significantly lower in the observed group respectively than those in the control group (P<0.05). Conclusion Dexmedetomide and with propofol combined with remifentanil can inhibit the cardiovascular response during tracheal intubation and extubation, decrease the dosage of propofol, increase the anesthesia effect, and make the hemodynamics more stable in the patients with cerebral aneurysms undergoing surgery.

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更新日期/Last Update: 2017-06-25