摘要
Abstract
Objective To observe the effects of dexmedetomidine of different target-controlled concentrations on cerebral oxygen metabolism in patients under general anesthesia for intracranial aneurysm operation.Methods A total of 58 patients to receive intracranial aneurysm operation in our hospital were randomly divided into groups A and B (n=29,respectively).Before anesthesia induction,the target-controlled infusion concentration of dexmedetomidine for group A was set as 3 ng/ml,while that for group B was 5 ng/ml;the same anesthesia induction and anesthesia maintenance programs were applied to the two groups.The hemodynamic indexes (HR and MAP) and cerebral oxygen metabolism indexes [D(a-jv)O2 and CEO2] of patients were respectively monitored upon entry to the operation room (T0),start of the operation (T1),occlusion of intracranial aneurysm (T2),recovery of aneurysm supply (T4),and at the end of the operation (T5).Meanwhile,the brain damage indexes (NSE,MBP and S100β protein) of patients were detected at T0,T5 and 24 h after the operation (T6),respectively.Results At T1-T3,the HR and MAP in the two groups decreased from T0 (P ＜ 0.05) but gradually restored,at T4-T5,to the levels at T0;the HR and MAP in the two groups at T1-T5 showed no significant differences (P ＞ 0.05).The decrease of the average D (a-jv) O2 and CeO2 at T1-T3 from those at T0 in group B was greater than that in group A (P ＜ 0.05);however,the D(a-jv) O2 and CeO2 in the two groups at T4-T5 restored to the levels at T0;there was no statistically significant difference between the two groups (P ＞ 0.05).The NSE,MBP and S100β protein at T6 in the two groups were higher than those at T0,with those in group B lower than those in group A (P ＜ 0.05).Conclusion The dexmedetomidine of 3 ng/ml and 5 ng/ml can maintain the stable hemodynamics in patients.Nevertheless,the dexmedetomidine of a target-controlled concentration of 5 ng/ml can better promote the stability of cerebral oxygen metabolism in patients and relieve brain damage.关键词
颅内/动脉瘤/右美托咪定/浓度/脑氧代谢Key words
intracranial aneurysm/dexmedetomidine/anaesthesia/concentration/cerebral oxygen metabolism分类
医药卫生
