| 王宏玉,滕秀飞,麻婷婷,朱俊超.不同剂量右美托咪定对脑额叶α1和θ频率的影响[J].,2018,(5):872-875 |
| 不同剂量右美托咪定对脑额叶α1和θ频率的影响 |
| Effects of Different Doses of Dexmedetomidine on the Frequency of α1-band and θ-band in the Frontal Lobe |
| 投稿时间：2017-07-18 修订日期：2017-08-12 |
| DOI：10.13241/j.cnki.pmb.2018.05.015 |
| 中文关键词: 盐酸右美托咪定 术后认知功能障碍 定量脑电图 α1、θ频率 |
| 英文关键词: Dexmedetomidine Postoperative cognitive dysfunction Quantitative electroencephalography α1-band, θ- band |
| 基金项目:国家自然科学基金项目（81401231） |
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| 中文摘要: |
| 摘要 目的：比较静脉滴注不同剂量盐酸右美托咪定对大脑额叶α1、θ频率定量脑电图(quantitative electroencephalography，QEEG)和血流动力学的影响。方法：选择择期下肢手术行椎管内麻醉患者60例并将其随机分为静脉输注盐酸右美托咪定0.6 μg/kg的高剂量组(H组，n=30)和0.3 μg/kg的低剂量组(L组，n=30)，麻醉方式均采用腰-硬联合阻滞麻醉，入室后监测脑电图至手术结束，选取患者入室5 min时(T0)、给药30 min时(T1)、手术结束时(T2)三个时刻前后无伪差脑电图60 s，观察并记录额叶θ和α1频段的功率。结果：H组血管活性药给药比例及阿托品给药次数≥2次的比例均显著高于L组(P<0.05)，而两组手术时间、术中失血量及术中输液量比较差异无统计学意义(P>0.05)。与T0时刻相比，两组T1时α1频段均下降，θ波频率升高，差别有统计学意义(P<0.05)，两组T2时α1频段和θ波频率均无明显变化。高剂量组低血压和心动过缓的发病率均高于低剂量组，差别有统计学意义(P<0.05)。结论：高、低剂量的盐酸右美托咪定对脑额叶α1和θ频率的影响相当，提示均可以预防术后认知功能障碍，但低剂量的盐酸右美托咪定对血流动力学影响更小。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effects of different doses of dexmedetomidine on the α1-band and θ-band on Frontal lobe by Quantitative Electroencephalography (QEEG) ) and hemodynamics. Methods: 60 patients undergoing elective lower limbs surgery were randomly divided into the intravenous infusion dexmedetomidine 0.6 ug/kg in high dose group(group H, n=30) and the 0.3 μg/kg in low dose group(group L, n=30). The anesthesia method we used was \the combined spinal-epidural anesthesia. Both groups were monitored the QEEG from the beginning to the end of surgery. The θ-band and α1-band frequency on frontal lobe for 60 s without artifact were ob- served and recorded. Three time points were selected: at 5 min after the patients enter the operating room (T0), at 30 min after administra- tion (T1) and at the end of the operation (T2). Results: The proportion of vasoactive drugs and the number of atropine administration≥2 times in the group H were significantly higer than those in the group L(P<0.05). But there was no significant difference between the two groups in the operation time, intraoperative blood loss and intraoperative infusion(P＞0.05). Compared with T0 time, the frequency of α1- band decreased and the frequency of θ- band increased at T1 in both groups were statistically significant (P<0.05). But both the frequency of α1-band and θ- band showed no significant change at T2 in the two groups. The incidence of hypotension and bradycardia in the high dose group was significantly higher than that in the low dose group (P<0.05). Conclusion: Both high and low doses of dexmedetomidine had comparable effect on the frequency of α1 and θ band in frontal lobe, suggesting that both high dose and low dose of dexmedetomi- dine can prevent the postoperative cognitive dysfunction. However, low dose of dexmedetomidine had less effect on the hemodynamics. |
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