PDF(Pubmed)
Abstract：
UNASSIGNED: There is limited literature wherein the hypotensive drugs have been compared to know the cerebral effects by monitoring regional cerebral oxygen saturation (rScO2). This study aimed to compare the effects of dexmedetomidine and nitroglycerin on rScO2 during controlled hypotensive anaesthesia using near-infrared spectroscopy (NIRS). The primary objective was to evaluate the non-inferiority of dexmedetomidine versus nitroglycerin in the occurrence of cerebral desaturation events (CDEs) during hypotensive anaesthesia.
UNASSIGNED: Adult patients scheduled to undergo head and neck surgery under general anaesthesia randomised to receive either dexmedetomidine or nitroglycerin infusion for controlled hypotensive anaesthesia. Cerebral oximetry was monitored with NIRS, and data regarding CDEs, bilateral rScO2, and peri-operative haemodynamics were collected. Continuous data were analysed using unpaired Student\'s t-tests except for intra-group analyses, which were analysed using paired t-tests. Categorical data were analysed using the Chi-square test. For comparison of time to CDEs, Kaplan-Meier survival analysis with log-rank test was performed.
UNASSIGNED: Of the 82 patients in both groups, CDEs were observed in 15 patients each. A decrease from baseline by 20% was observed in three patients: one in Group N and two in Group D. Statistically, there was an equal risk of getting CDEs in the groups. The time to CDE was comparable (P > 0.05). The difference in heart rate was statistically significant (P < 0.001).
UNASSIGNED: Dexmedetomidine is non-inferior to nitroglycerin in terms of the occurrence of cerebral desaturation events when used for controlled hypotensive anaesthesia in head and neck surgeries.
UNASSIGNED: Adult patients scheduled to undergo head and neck surgery under general anaesthesia randomised to receive either dexmedetomidine or nitroglycerin infusion for controlled hypotensive anaesthesia. Cerebral oximetry was monitored with NIRS, and data regarding CDEs, bilateral rScO2, and peri-operative haemodynamics were collected. Continuous data were analysed using unpaired Student\'s t-tests except for intra-group analyses, which were analysed using paired t-tests. Categorical data were analysed using the Chi-square test. For comparison of time to CDEs, Kaplan-Meier survival analysis with log-rank test was performed.
UNASSIGNED: Of the 82 patients in both groups, CDEs were observed in 15 patients each. A decrease from baseline by 20% was observed in three patients: one in Group N and two in Group D. Statistically, there was an equal risk of getting CDEs in the groups. The time to CDE was comparable (P > 0.05). The difference in heart rate was statistically significant (P < 0.001).
UNASSIGNED: Dexmedetomidine is non-inferior to nitroglycerin in terms of the occurrence of cerebral desaturation events when used for controlled hypotensive anaesthesia in head and neck surgeries.
摘要：
有有限的文献通过监测局部脑氧饱和度(rScO2)来比较降血压药物以了解脑效应。本研究旨在使用近红外光谱（NIRS）比较右美托咪定和硝酸甘油对控制性降压麻醉期间rScO2的影响。主要目的是评估右美托咪定与硝酸甘油在低血压麻醉期间发生脑去饱和事件（CDEs）中的非劣效性。
■计划在全身麻醉下接受头颈部手术的成年患者随机接受右美托咪定或硝酸甘油输注控制性降压麻醉。使用NIRS监测脑氧饱和度，和有关CDE的数据，收集双侧rScO2和围手术期血流动力学。除组内分析外，连续数据使用非配对学生t检验进行分析。使用配对t检验进行分析。分类数据采用卡方检验进行分析。为了比较CDE的时间，采用对数秩检验进行Kaplan-Meier生存分析。
■在两组的82名患者中，在15例患者中观察到CDE。在三名患者中观察到从基线下降了20％：N组中有一名，D组中有两名。在组中获得CDE的风险相等。CDE时间具有可比性（P>0.05）。心率差异有统计学意义(P<0.001)。
■右美托咪定用于头颈部手术的控制性降压麻醉时，在脑去饱和事件的发生方面不劣于硝酸甘油。
■计划在全身麻醉下接受头颈部手术的成年患者随机接受右美托咪定或硝酸甘油输注控制性降压麻醉。使用NIRS监测脑氧饱和度，和有关CDE的数据，收集双侧rScO2和围手术期血流动力学。除组内分析外，连续数据使用非配对学生t检验进行分析。使用配对t检验进行分析。分类数据采用卡方检验进行分析。为了比较CDE的时间，采用对数秩检验进行Kaplan-Meier生存分析。
■在两组的82名患者中，在15例患者中观察到CDE。在三名患者中观察到从基线下降了20％：N组中有一名，D组中有两名。在组中获得CDE的风险相等。CDE时间具有可比性（P>0.05）。心率差异有统计学意义(P<0.001)。
■右美托咪定用于头颈部手术的控制性降压麻醉时，在脑去饱和事件的发生方面不劣于硝酸甘油。
