麻醉安全与质控2025，Vol.7Issue(4)：277-282,6.DOI:10.3969/j.issn.2096-2681.2025.04.002
右美托咪定对急性缺血性脑卒中机械取栓全麻患者苏醒质量及早期神经功能恢复的作用
Effect of dexmedetomidine on awakening quality and early neurological function recovery in patients with acute ischemic stroke undergoing mechanical thrombec-tomy under general anesthesia
摘要
Abstract
Objective To observe the effect of dexmedetomidine(Dex)combined with general anesthesia on the awakening quality and early neurological function recovery in patients with acute ischemic stroke(AIS)undergoing mechanical thrombectomy(MT).Methods A total of 68 patients,aged 50-75 years old,with body mass index(BMI)＜30 kg/m2,of American Society of Anesthesiologists(ASA)physical status classification Ⅰ or Ⅱ,who underwent elective MT in the Department of Neurosurgery of People's Hospital of Xinjiang Uygur Autonomous Region from August 2023 to October 2024 were selected.The patients were divided into the conventional group(n=34)and the dexmedetomidine group(Dex group,n=34)by the random number table method.In the Dex group,Dex was intravenously pumped at a dose of 0.5 μg/kg before anesthesia induction and pumped out within 10 min.In the conventional group,an equal amount of normal saline was pumped in the same time.The two groups of patients underwent anesthesia induction immediately after the drug infu-sion.The indexes of heart rate(HR),diastolic blood pressure(DBP)and systolic blood pressure(SBP)at each time point before anes-thesia induction(T1),at the start of the operation(T2),and after thrombectomy and extubation(T3)were observed and recorded.The levels of neuron-specific enolase(NSE),S100-β protein,and inflammatory factors interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)at T1,T3,and 24 h after the operation(T4)were measured.The neurological function of the patients was evaluated by the National Institutes of Health Stroke Scale(NIHSS)at T1 and T4.The recovery quality of the patients was evaluated,and the incidence of adverse reactions was counted.Results At T1,the HR,DBP,and SBP of the patients in the two groups were lower than those at T2 and T3.The HR,DBP,and SBP of the patients in the conventional group were higher than those in the Dex group,and the differences were statistically significant(P＜0.05).The levels of NSE,S100-β,IL-6,and TNF-α at T3 and T4 in the two groups were higher than those at T1,and the levels of NSE,S100-β,IL-6,and TNF-α at T3 and T4 in the Dex group were lower than those in the conventional group(P＜0.05).The NIHSS scores of the two groups at T4 were lower than those at T1,and the NIHSS score of the Dex group at T4 was lower than that of the conventional group(P＜0.05).The recovery time,Steward recovery score,and the incidence of postoperative delirium in the Dex group were less than those in the conventional group,and the differences were statistically significant(P＜0.05).The incidence of adverse reactions in the Dex group was lower than that in the conventional group,but there was no statistical significance between the two groups(P＞0.05).Conclusion As an adjuvant drug for general anesthesia,Dex demonstrates significant anesthetic advantages in MT for AIS.It can effectively reduce hemodynamic fluctuations,accelerate the recovery of postoperative neurological function,improve the recovery quality of patients,and exhibit a high safety profile.关键词
右美托咪定/急性缺血性脑卒中/机械血栓切除术/苏醒质量/神经功能Key words
dexmedetomidine/acute ischemic stroke/mechanical thrombectomy/recovery quality/neurological function引用本文复制引用
陈楠,冯冠军,于志超,徐桂萍..右美托咪定对急性缺血性脑卒中机械取栓全麻患者苏醒质量及早期神经功能恢复的作用[J].麻醉安全与质控,2025,7(4):277-282,6.基金项目
新疆维吾尔自治区重点研发计划项目(2022B03009-4) （2022B03009-4）
