| 黄 昕,杨延超,滕秀飞,万玉骁,李 阳,魏 巍,李秀艳,刘诗煜,史胜哲,朱俊超.不同浓度右美托咪定对低血红蛋白全麻患者脑氧饱和度的影响[J].,2019,19(2):258-261 |
| 不同浓度右美托咪定对低血红蛋白全麻患者脑氧饱和度的影响 |
| Effect of Different Concentrations of Dexmedetomidine on the Cerebral Oxygen Saturation of Low Hemoglobin Patients under General Anesthesia |
| 投稿时间：2018-03-28 修订日期：2018-04-25 |
| DOI：10.13241/j.cnki.pmb.2019.02.012 |
| 中文关键词: 脑氧饱和度 右美托咪定 血红蛋白 近红外光谱技术 |
| 英文关键词: Cerebral oxygen saturation Dexmedetomidine Hemoglobin concentration Near infrared spectroscopy |
| 基金项目:辽宁省自然科学基金项目（20102282） |
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| 中文摘要: |
| 摘要 目的：探讨不同浓度右美托咪定(Dex)对低血红蛋白全麻患者脑氧饱和度(rSO2)的影响。方法：选取行择期全麻开腹妇科手术、血红蛋白在8~9 g/dl的女性患者60例，根据不同浓度右美托咪定随机分为D1(0.1 μg·kg-1·h-1)、D2(0.3 μg·kg-1·h-1)、D3(0.5 μg·kg-1·h-1)以及C组(等量0.9%生理盐水组)，每组15例。D1~D3组患者入室后于麻醉开始前均给予0.5 μg·kg-1负荷剂量右美托咪定于15 min内泵入。四组麻醉诱导后，均行七氟醚复合瑞芬太尼静吸复合麻醉维持，D1~D3组泵入相应浓度剂量的右美托咪定，C组泵入等量的生理盐水，直至手术结束前40 min停止泵入。在诱导前开始记录患者以下变量基线值：平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、脑氧饱和度(rSO2)、脑电双频指数(BIS)、以及腋温(T)。并在术中相对平稳期同样记录以上变量数值以及呼吸末二氧化碳浓度(PETCO2)，每3 min记录一次，共记录30 min。结果：四组患者入室后脑氧饱和度、平均动脉压、心率、指脉氧饱和度、腋温组间比较差异无统计学意义(P>0.05)。与D1组比较、D2组脑氧饱和度较高；与D2组比较，D3组脑氧饱和度较高，差异有统计学意义(P <0.05)。在一定剂量范围内应用右美托咪定，可使低血红蛋白患者术中脑氧饱和度随泵入右美托咪定剂量的增加而增加, 并且这一关系具有线性相关性(P<0.05，相关系数r=0.9999)。结论：在一定剂量范围内应用右美托咪定可使低血红蛋白患者术中脑氧饱和度随应用右美托咪定剂量增加而增加，对于改善患者预后起着积极作用。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the effect of applying different concentrations of dexmedetomidine (Dex) to low hemoglobin patients on cerebral oxygen saturation (rSO2) under general anesthesia. Methods: Select sixty female patients with hemoglobin concentra- tion between 8 to 9 g/dl. They are all scheduled for elective intraabdomenally gynecologic operation, and were randomly divided into four groups according to the different concentrations of dexmedetomidine: D1 (0.1 μg·kg-1·h-1), D2 (0.3 μg·kg-1·h-1), D3 (0.5μg·kg -1·h-1) and group C(given the equivalent amount of 0.9 % saline), each group is composed of 15 patients. Before anesthesia induction, D1~D3 groups were all given 0.5 μg/kg loading dose of Dex, which was required to be pumped within 15 min for each patient. After anesthesia induction, four groups all underwent sevoflurane and remifentanil intravenous-inhalation combined anesthesia, D1~D3 group were given the corresponding concentration of dexmedetomidine, whereas group C given equivalent amount of saline. All the injection was stopped 40 min before the end of surgery. Record the patients' following baseline variables before induction: mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2), cerebral oxygen saturation (rSO2), bispectral index(BIS), and axillary temperature(T). Select a rela- tively stable period during surgery and record the variables mentioned above as well as end-tidal pressure of carbon dioxide (PETCO2) at every 3 min for 30 min. Results: There was no significant difference in the cerebral oxygen saturation, mean arterial pressure, heart rate, pulse oxygen saturation, and axillary temperature between the four groups(P>0.05). Compared with group D1, cerebral oxygen saturation was higher in group D2. Compared with group D2, cerebral oxygen saturation was higher in group D3(P<0.05). When increasing the ap- plication of dexmedetomidine within a certain dose range in patients of low hemoglobin can increase the cerebral oxygen saturation, and this relationship has a linear correlation(P<0.05), with a correlation coefficient of r=0.9999, and a linear regression equation of y=12.45x+56.005. Conclusion: Applying dexmedetomidine at a certain dose range, can increase low hemoglobin patients cerebral oxygen saturation as the dexmedetomidine dose increases. |
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