目的 研究右旋美托咪啶(dexmedetomidine,Dex)对听觉诱发电位指数(auditory evoked potential index, AAI)的影响和气管插管血流动力学的影响。方法 择期手术患者60例(ASA Ⅰ～Ⅱ级),采用随机数字表法随机分成Dex组(D组)和对照组(C组):D组静脉泵注Dex负荷剂量1 μg/kg(20 min泵完);C组以同样方式泵注生理盐水。泵注完成2 min后诱导插管，记录泵药前（T0）、诱导前（T1）、插管前（T2）、插管后即刻（T3）、插管后3 min（T4）、5 min (T5)、10 min（T6）的SBP、MAP、DBP、HR、SＰO2和AAI。结果 两组患者术前一般情况基本相同，D组的AAI值在T0和T1时点分别为（61.8±5.3）和（35.0±5.7）（P<0.01），下降约53%，而C组的AAI值在泵药前后无明显变化。在插管后即刻D组的SBP、MAP、DBP和HR分别为[（112±18）、（90±19）、（80±19）、（81±14）mmHg(1 mmHg=O．133kPa)]，与C组[（140±21）、（109±16）、（97±17）、（95±10）mmHg]比较差异有统计学意义（P<0.05）。结论 右旋美托咪啶可以产生良好的镇静，并且能够抑制患者的气管插管血流动力学反应。
Objective To study the influence of dexmedetomidine on auditory evoked potential index and tracheal intubation. Methods 60 patients were randomized divided into dexmedetomidine group(D group) or control group(C group). Patients were administered dexmedetomidine at a dose of 1 μg/kg in 20 minutes in D group, the same volume placebo was administered in C group. Tracheal intubation was done 2 minutes after medication. Systolic bloodpressure, mean arterial pressure, diastolic blood pressure, heart rates, pulse oxygen saturation and auditory evoked potential index were recorded at the following time points(before medication, before induction,before intubation, the time after intubation, 3 minutes after intubation, 5 minutes after intubation and 10 minutes after intubation). Results Before medication, the general conditions have no difference in two groups. The value of AAI at before medication and before induction were （61.8±5.3） and （35.0±5.7）（P<0.05）,decreased by 53%,and there were no difference in C group. The systolic blood pressure, mean arterial pressure, diastolic blood pressure and heart rates at the time after intubation in D group were（112.0±18.5),（90.0±19.2）,（80.2±19.4）and（80.8±13.7）mmHg respectively ,while in C group were （140±21）、（109±16）、（97±17）、（95±10）mmHg respectively,there were significant difference between two groups（P<0.05）. Conclusions Dexmedetomidine has good sedative effects before surgery, and it can also depress the stress responses of tracheal intubation effectively.
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