小剂量芬太尼-罗哌卡因鞍麻在肛肠手术中的应用.doc

右美托咪定辅助全麻在 （1.徐州市中医院麻醉科，江苏 徐州 221009；2.徐州市中心医院，江苏 徐州 221009） 摘要 目的 研究右美托咪定辅助全麻在中的临床应用至31-60岁，体重指数18～28 kg/m2，ASA分级Ⅰ～Ⅱ级，依据DAS软件将病人随机分成两组 (n=20)：对照组(C组)和右美托咪定组(Dex组)。Dex组在常规麻醉前10 min经静脉输注右美托咪定1μg/ kg，随后以0.5μg.kg-1.h-1的速率静脉常规给予等量的生理盐水。(T0)、术中面神经与血管分离时（）(T2) 三个时间点检测患者0、1及2时血中去甲肾上腺素(NE)、血浆皮质醇(cortisol，Cor)、C反应蛋白(C-reactive protein，CRP)及血糖（Blood Glucose，GLU）的浓度，同时0、1及2时平均动脉压（）心率（）血氧饱和度的变化(T0)、手术结束后即刻(T2)、手术结束后12小时(T3)和手术结束4小时(T4)四个时间点抽取静脉血，检测T0、T2、T3及T4时间点的患者血清神经元特异生烯醇( neuron-specific enolase , NSE)、S-100β蛋白浓度。结果 DEX组与对照组相比，在T0、1及2时三个时间点心率（HR）、平均动脉压（MAP）相互间存在显著性差异（P0.05）；而血氧饱和度（sao2）相互间无显著性差异（P0.05）；DEX1及2两个时间点血浆皮质醇(Cor)、C反应蛋白(CRP)、去甲肾上腺素(NE)及血糖（GLU）浓度相互间存在显著性差异（P0.05）；DEX组与对照组相比，在T2、T3、4时S-100β、NSE的浓度明显下降，(P0.05)；μg/kg，随后以0.5μg.kg-1.h-1的速率静脉影响小，明显患者的，中SE与S-100β蛋白浓度，脑保护，患者的安全有效的方法 关键词：右美托咪定；辅助全麻；面肌痉挛；临床 Clinical Study of Dexmedetomidine assisted anesthesia in patients with Hemifacial spasm undergoing Surgery CAO Yong1， ZHAO Li2，ANG Li-wei2，WANG Pei-an， Yu-gang1, ZHANG Pei-ying2. (1.Department of Anesthesiology, Traditional Chinese Medicine Hospital of Xuzhou, Xuzhou, 221009, China;2. Xuzhou City Central Hospital, Xuzhou, 221009, China) Abstract Objective To investigate the Clinical observation of Dexmedetomidine assisted anesthesia in patients with hemifacial spasm undergoing Surgery. Methods Based on 2015 January to 2016 May in our hospital forty patients with hemifacial spasm , age 31-60 year, with mass index of 18 ~ 28 kg/m2, ASA physical statusⅠ~Ⅱ, were randomized design into 2 groups (n = 20 each): control group (group C) and dexmedetomidine group (group Dex). Two groups of patients were routinely undergoing general anesthesia，In group Dex, dexmedetomidine 1μg/kg were infused intravenously over 10 min beforer anesthesia, followed by infusion at a rate of 0.5μg.kg-1.h-1 until the end of operation. The equal volume of normal saline was given in group C.Immediately before beginning of surgery (T0), Intraoperative the facial nerve and vascular separation (T1),Imm