右美托咪定对脑组织氧合的频域近红外光谱研究

Rodolfo G. Gatto, W. Hoffman, C. Paisansathan, V. Baughman, F. Charbel
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引用次数: 1

摘要

右美托咪定(DEX)是一种选择性α - 2肾上腺素能激动剂,可产生脑血管收缩。我们采用频域近红外光谱(FD-NIRS)研究了静脉注射DEX时脑氧合情况。对4例无脑病理的神经外科患者进行左、额叶血红蛋白(OHb)、脱氧血红蛋白(hbb)、脑氧饱和度(SO2)和总血红蛋白(tHb)的测定。使用便携式脑氧计oxplex TS (ISS, Champaign, IL)进行测量。地氟醚麻醉初期给予右美托咪定0.2 mcg/kg减轻高血压。在给药过程中,脑区OHb由17.7±6.9Mol/L降至16.1±6.3Mol/L (p < 0.05), SO2由61±12%降至58±12% (p < 0.05)。hbb从10.5±2.8Mol到10.5±2.7Mol/L没有变化。脑氧合在5分钟内恢复到dex前的水平。给药后,观察到OHb小幅但持续下降,可能是由局部血管收缩作用介导的。DEX治疗后脑氧合短暂下降,但hbb的产生没有增加。
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Dexmedetomidine Effects on Brain Tissue Oxygenation Measured by Frequency Domain Near Infrared Spectroscopy
Dexmedetomidine (DEX) is a selective alpha2-adrenergic agonist that produces cerebral vasoconstriction. We used frequency domain near infrared spectroscopy (FD-NIRS) to study brain oxygenation during DEX intravenous bolus injection. Oxyhemoglobin (OHb), deoxyhemoglobin (HHb), brain oxygen saturation (SO2) and total hemoglobin (tHb) were acquired on the frontal right and left side in 4 neurosurgery patients without cerebral pathology. Measurements were performed using a portable brain oxymeter, Oxiplex TS (ISS, Champaign, IL). Dexmedetomidine 0.2 mcg/kg was given to attenuate hypertension during the initial stages of desflurane anesthesia. During DEX administration, regional cerebral OHb decreased from 17.7 ± 6.9 Mol/L to 16.1 ± 6.3 Mol/L (p < 0.05) and SO2 from 61 ± 12 % to 58 ± 12 % (p < 0.05). HHb did not change from 10.5 ± 2.8 Mol to 10.5 ± 2.7 Mol/L. Recovery of brain oxygenation to pre-DEX levels occurred within 5 minutes. After administration of DEX, a small but consistent decrease in OHb was observed, probably mediated by a local vasoconstrictor effect. Brain oxygenation decreased transiently with DEX treatment without an increase in HHb production.
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