标题：右美托咪定在神经外科气管切开术中的应用

      作者：李 刚，任长和，段晓霞，代俊超
    (泸州医学院附属医院麻醉科，四川 泸州 646000)

      卷次： 2014年25卷2期

      【摘要】 目的 观察盐酸右美托咪定在神经外科气管切开术中的临床应用效果。方法 60例神经外科需
行气管切开术的患者，随机分为右美托咪定组(D组)和对照组(C组)，D组术前先静脉泵注右美托咪定0.5 μg/kg，
后以0.5 μg/(kg·h)速率泵注至术毕。C组输注相同容量的生理盐水。两组均在局麻下完成气管切开手术。记录
两组患者麻醉前(T0)，注射局麻药(T1)，气管操作(T2)及术毕(T3) SBP、DBP、HR、RR和SpO2。记录两组需乌拉地尔
的病例数和术中挣扎躁动患者的病例数。结果 与T0时点比较，C组T1，T2时点HR、SBP、DBP、RR均明显升高
(P＜0.01)。D组SBP、DBP在T1，T2低于T0，HR，RR在T1时点低于T0但T2时点高于T0 (均P＜0.01)；在T1，T2，T3各
个时点，D组HR、SBP、DBP、RR均低于C组(P＜0.01)。D组患者术中使用乌拉地尔和挣扎躁动的发生频率均低
于C组(P＜0.01)。结论 右美托咪定可以减轻神经外科患者气管切开术中应激反应，减少血流动力学波动和躁
动，对呼吸无抑制，值得临床推广。

      【关键词】 右美托咪定；神经外科；气管切开术

      【中图分类号】 R741.05 【文献标识码】 A 【文章编号】 1003—6350（2014）02—0262—03


Application of dexmedetomidine in tracheotomy for neurosurgical patients.
LI Gang, REN Chang-he, DUAN
Xiao-xia, DAI Jun-chao. Department of Anesthesiology, Affiliated Hospital of Luzhou Medical Collage, Luzhou 646000,
Sichuan, ,CHINA

【Abstract】 Objective To investigate the clinical application of dexmedetomidine hydrochloride in tracheoto-
my for neurosurgical patients. Methods Sixty neurosurgical patients underwent tracheotomy surgery were randomly
divided into dexmedetomidine group (group D) and control group (group C). Dexmedetomidine 0.5 μg/kg was infused
slowly in 10 min in patients of group D by intravenous pump before operation, then at 0.5 μg/ (kg.h) continuously un-
til the end of the operation. The same volume of saline was infused continuously until the end of the operation in
group C. Both two groups of tracheotomy surgery were completed under local anesthesia. The patients' systolic blood
pressure(SBP), diastolic blood pressure (DBP), heart rate (HR), saturation of pulse oxygen (SpO2) and respiratory rate
(RR) were recorded in two groups at the following time points: before anesthesia (T0), local anesthetic injection (T1)，
trachea stimulation (T2), end of the operation (T3). The cases of urapidil injected，agitation and dysphoria were record-