失眠对右美托咪定镇静效能影响的研究-第三军医大学学报.doc

Narcotrend用于失眠对右美托咪定镇静深度影响的研究 黄嵘虎，葛衡江? 通讯作者 联系电话（第三军医大学大坪医院野战外科研究所麻醉科，重庆 400042） 摘要 目的：探讨失眠对右美托咪定镇静深度的影响。方法：采用随机抽样法选择40例作为研究对象，其中20例被诊断为失眠且有明显的睡眠剥夺症状作为试验组（A组），另20例没有失眠症者作为对照组（B组）。分别对A、B两组进行右美托咪定镇静，均先进行10分钟1ug/kg的泵注诱导，然后泵注20分钟（0.2ug/kg/h）维持。监测两组的Narcotrend指数（NI）值、平均动脉压、心率、OAA/S（Observers’Assessment of Alertness/Sedation 镇静/警觉评分）值。结果：试验组的NI值、心率和对照组比较有统计学差异，试验组的NI值偏高而心率值偏低;但是试验组中出现OAA/S值为1的却较对照组例数多，且有明显统计学意义（P0.05）。两组NI值和OAA/S值均呈直线相关，有统计学意义（P0.05）。结论：失眠所引起的睡眠剥夺能够增加右美托咪定的镇静作用，而Narcotrend指数在右美托咪定镇静时，能够准确预测人的意识水平。 关键词：镇静深度；失眠；睡眠剥夺；右美托咪定；Narcotrend 中图分类号：R614.1;R256.23 Influence of insonia on sedation by dexmedetomidine with Narcotrend Huang Ronghu，Ge Hengjiang （Department of Anesthesiology，Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing 400042,china） [Abstract] Objective To investigate the sedative effect of dexmedetomidine on insomnia with sleep deprivation. Methods Using convenience sampling method,20 patients with insomnia and 20 patients without insomnia were enrolled in the study. With patients written in formed consent, all the subject were treated by dexmedetomidine induced sedation. Comparisons were conducted in the sedative effect between insomnia and not insomnia people using the records of Narcotrend Index (NI).Result Comparison of NI and HR showed a significant difference between the two group (P0.05). The Narcotrend index The insomnia group was higher and the HR was lower than another group ,but its OAA/S score with “1” is lower .The NI was positively correlated to the OAA/S score. Conclusion Insomnia with sleep deprivation significantly potentiated the ability of dexmedetomidine to induce a sedation. NI may serve as an objective index for sedation assessment. [key words] sedation deep；insomnia;sleep deprivation；dexmedetomidine；Narcotrend 随着现代生活节奏的加快，失眠成为一种被广泛问诊的疾病。失眠和睡眠剥夺，加剧日间躯体机能紊乱，影响人们正常的工作和生活。从麻醉和睡眠的行为学相似性的研究来看，麻醉和睡眠可能拥有共同的神经生理方面的基础。麻醉药物诱导出现的无意识状态可能缘于某些神经元的相互作用，而这些神经元参与调解睡