中文摘要：

目的：观察术前辅用右美托咪定对颈椎手术患者麻醉恢复期的影响。方法选择40例行颈椎手术的颈椎受限患者，随机分成右美托咪定组（D组，n＝20）和生理盐水组（N组，n＝20）。D组于诱导前10 min静脉泵注右美托咪啶1μg/kg，N组静脉泵注相同容量的生理盐水。行颈椎手术的颈椎受限患者术中均以瑞芬太尼（血浆浓度，4 ng/mL）和丙泊酚（血浆浓度，据术中血压调节）靶控输注维持麻醉。记录各组给药前（T1）、拔管时（T2）及拔管后10 min（T3）、30 min（T4）、60 min（T5）的动脉压（MAP）、心率（HR）、脉搏血氧饱和度（SpO2）、Ramsay镇静评分，记录患者停药拔气管时间、对口头指令反应时间；T3-T5视觉模拟评分法（VAS）疼痛评分；记录拔管后苏醒期内患者呼吸抑制、烦躁、恶心呕吐和疼痛等不良反应的情况。结果两组患者拔管时间、对口头指令反应时间比较，差异无统计学意义（P＞0.05）；D组T2～T5时点MAP、HR 明显低于N组， D组T3～T5时点VAS明显低于N组；D组Ramsay评分优于N组，且烦躁、恶心呕吐及疼痛等不良反应明显低于N组，差异均具统计学意义（P＜0.05）；D组T2时点MAP、HR 明显高于T1，N组T2时点MAP、HR 明显高于其他时点；D组及N组T5时点VAS明显高于T3～T4，差异有统计学意义（P＜0.05）。结论颈椎手术患者术前辅用右美托咪定，患者在麻醉恢复期血流动力学稳定，苏醒期呼吸、意识恢复和拔管条件不受影响，且烦躁、恶心呕吐和疼痛等不良反应减少。

英文摘要：

Objective To investigate the influence of preoperatiive dexmedetomidine to anesthesia recovery in patients undergoing cervical operations.Methods 40 patients were randomly allocated in two groups： Dexmedetomidine group（D group,n=20）, normal saline group（N group,n=20）. Dexmedetomidine 1.0μg/kg was administered in patients in D group 10 minutes before induction. Meanwhile normal saline of the same volume was administered in patients in N group. Anesthesia is maintained by a target-controlled infusion（TCI） of remifentanil（plasma concentration, 4ng/ml） and propofol（plasma concentration, infusion rate adapted by blood pressure）. Mean arterial pressure（MAP）, heart rate（HR）, saturation of pulse oximetry （SpO2） and ramsay sedation score of baseline（T1）, extubation（T2）,10min after extubation（T3）, 30min after extubation（T4） and 60min after extubation （T5） were recorded, as well as time to extubation, time to response to verbal command. Adverse events such as respiratory depression, dysphoria, nausea and vomiting and pain are analyzed.Results No difference is shown in time to extubation and time to response to verbal command（P〉0.05）. Compared with N group, MAP, HR are lower at T2-T5 in D group, VAS in T3-T5 are lower in D group,Ramsay score is better in D group, adverse events are less in D group. Within D group, MAP and HR at T2 are lower than those at T1.In N group, MAP and HR at T2 are higher. VAS at T5 in both groups are higher than T3-T4（P〈0.05）Conclusion Preoperative dexmedetomidine in patients undergoing cervical operations are effective and safe for it stabilizes MAP and HR, does not compromise respiration, consciousness and extubation in anesthesia recovery period, and lessen dysphoria, nausea and vomiting and pain.