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目的 探讨右美托咪定对心脏不停跳冠状动脉搭桥术(CABG)患者麻醉苏醒期认知功能的影响.方法 行心脏不停跳CABG患者60例随机均分为三组:麻醉诱导前10 nin内,A组泵入右美托咪定1.0 μg/kg,B组泵入地佐辛0.1mg/kg,C组泵人生理盐水20 ml.拔管后30 min,评估VAS疼痛评分、Ramsay镇静评分和谵妄分级评分;术后第1、7天,评估认知功能,检测血清神经元特异性烯醇化酶(NSE)和IL-6表达.结果 拔管后30 min,A、B组VAS疼痛评分低于C组,A组Ramsay镇静评分和谵妄分级评分优于B、C组(P＜0.05).术后第1天,A组认知功能障碍发生率为5.0％(1/20),低于B组的15.0％(3/20)和C组的35.0％ (7/20)(P＜0.05).术后第1天,A组血清NSE和IL-6水平低于B、C组(P＜0.05).结论 麻醉诱导前应用右美托咪定能降低心脏不停跳CABG患者苏醒期认知功能障碍发生率,其作用可能与降低血清NSE和IL-6水平有关.“,”Objective To study the effect of dexmedetomidine on cognitive function during recovery period of general anesthesia in the patients after off-pump coronary artery bypass grafting (CABG).Methods A total of 60 patients undergoing off-pump CABG was randomly assigned into three groups with 20 cases each.In 10 minutes before anesthesia induction,the patients were infused dexmedetomidine 1.0 μg/kg(group A),dezocine 0.1 mg/kg(group B) or normal saline 20 ml(group C).The VAS pain score,Ramsay sedation score and delirium rating scale score were evaluated at 30 minutes after extubation.On the 1stand 7th day after surgery,the cognitive dysfunction was evaluated and serum levels of neuron specific enolase(NSE) and IL-6 were detected.Results The VAS pain score was less in groups of A and B than that in group C at 30 minutes after extubation(P＜0.05).Ramsay sedation score and delirium rating scale score were better in group A than those in groups of B and C(P＜0.05).The cognitive dysfunction rate of group A was 5.0％ (1/20) on the 1st day after surgery,which was lower than 15.0％(3/20) in group B and 35.0％(7/20) in group C(P＜0.05).Serum levels of NSE and IL-6 were significantly lower in group A than those in groups of B and C (P＜0.05).Conclusion Application of dexmedetomidine before anesthesia induction can reduce the incidence of cognitive dysfunction during recovery period of general anesthesia in the patients undergoing off-pump CABG,which may be related to a decrease of serum NSE and IL-6 levels.