Ozkose Zerrin, Demir Figen Sunay, Pampal Kutluk, Yardim Sahin
Department of Anesthesiology and Reanimation, Gazi University School of Medicine, Ankara, Turkey.
Tohoku J Exp Med. 2006 Oct;210(2):153-60. doi: 10.1620/tjem.210.153.
The alpha2-agonist dexmedetomidine (Dex), a sedative and analgesic, reduces heart rate (HR) and blood pressure, and has been used in the practice of anesthesia. In this study, we aimed to evaluate the effects of Dex on hemodynamic variables, anesthetic sparing effects, and recovery profiles in patients who underwent surgery in prone position. The prone position itself can cause a decrease in the systemic blood pressure. Forty patients who undergo lumbar discectomy were randomly assigned to receive either Dex (a loading dose 1 microg/ kg in 10 minutes followed by an infusion rate of 0.2 microg/ kg/ hr) or saline. In both groups, the anesthesia was induced with fentanyl, thiopental and rocuronium, and maintained with desflurane in 50% N(2)O. Mean arterial blood pressure (MAP), HR, cardiac output (CO), and level of anesthesia were monitored. Recovery times and analgesic requirements were also recorded. As a response to endotracheal intubation, a significant increase in MAP and HR was observed in the control group compared to the Dex group, but no difference in CO. The recovery times were significantly shorter in the Dex group compared to the control group. Anesthetic and analgesic requirements of the Dex group were lower than controls. Thus, the use of Dex caused no detrimental effects on the hemodynamic variables in prone position. In addition, Dex decreased pressure response to intubation, and anesthetic and analgesic requirements, shortened recovery times, and decreased postoperative pain level. Dex may be an alternative to currently used adjunctive anesthetic agents in lumbar discectomy operations.
α2 激动剂右美托咪定（Dex）是一种镇静镇痛药，可降低心率（HR）和血压，已用于麻醉实践。在本研究中，我们旨在评估 Dex 对俯卧位手术患者血流动力学变量、麻醉节省效应及恢复情况的影响。俯卧位本身可导致全身血压下降。40 例行腰椎间盘切除术的患者被随机分配接受 Dex（负荷剂量 1 微克/千克，10 分钟内输注完毕，随后以 0.2 微克/千克/小时的速率输注）或生理盐水。两组均采用芬太尼、硫喷妥钠和罗库溴铵诱导麻醉，并用 50%氧化亚氮中的地氟醚维持麻醉。监测平均动脉血压（MAP）、HR、心输出量（CO）及麻醉深度。记录恢复时间和镇痛需求。作为对气管插管的反应，与 Dex 组相比，对照组的 MAP 和 HR 显著升高，但 CO 无差异。与对照组相比，Dex 组的恢复时间显著缩短。Dex 组的麻醉和镇痛需求低于对照组。因此，Dex 的使用对俯卧位患者的血流动力学变量无不良影响。此外，Dex 降低了对插管的压力反应、麻醉和镇痛需求，缩短了恢复时间，并降低了术后疼痛程度。在腰椎间盘切除术中，Dex 可能是目前使用的辅助麻醉剂的替代品。
