中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (9): 843–847.doi: 10.12007/j.issn.0258-4646.2016.09.017

• 论著 • 上一篇    下一篇

右美托咪定预防七氟醚麻醉下麦粒肿手术小儿苏醒期躁动的研究

乔海峰,陈宏志   

  1. 中国医科大学附属盛京医院麻醉科,沈阳 110004
  • 收稿日期:2015-11-28 出版日期:2016-09-28 发布日期:2016-08-29
  • 通讯作者: 陈宏志 E-mail:chenhz@sj?hospital.org
  • 作者简介:乔海峰(1988 -),女,硕士研究生 .

Dexmedetomidine Prevents Emergence Agitation after Hordeolum Incision in Young Children by Sevoflurane Anesthesia

QIAO Haifeng,CHEN Hongzhi   

  1. Department of Anesthesia,Shengjing Hospital,China Medical University,Shenyang 110004,China
  • Received:2015-11-28 Online:2016-09-28 Published:2016-08-29

摘要: 目的 探讨右美托咪定预防七氟醚麻醉下行麦粒肿手术小儿苏醒期躁动的有效性及安全性。方法 将 2014 年 12 月至2015 年 3 月 60 例择期行眼科麦粒肿手术的小儿(1~3 岁)随机均分为 3 组:安慰剂组(NS 组)、低剂量右美托咪定组(D0.5 组)、高 剂量右美托咪定组(D1.0 组),同时取得患儿家属知情同意。3 组均使用七氟醚麻醉诱导及维持,静脉通路连接后,D1.0 组、D0.5 组、NS 组患儿分别接受右美托咪定 1.0 μg/kg、0.5 μg/kg、等量生理盐水静脉 10 min 泵入。记录患儿手术及术后苏醒室(PACU) 的心率和血氧饱和度,标记患儿麻醉开始时、停止七氟醚吸入时、自主呼吸恢复时及拔管的时间,患儿入 PACU 后每 10 min 记录1 次生命体征及 Cravero 量表躁动评分。结果 D1.0 组及 D0.5 组在拔管时及拔管后 5 min 的躁动发生率均低于 NS 组(P <0.05);而 D1.0 组与 D0.5 组的躁动发生率在各个时间点差异无统计学意义(P > 0.05)。D1.0 组的自主呼吸恢复时间与 NS 组比 较差异无统计学意义(P > 0.05),而 D1.0 组拔管时间长于 NS 组(P < 0.05),D0.5 组的自主呼吸恢复时间及拔管时间与 NS 组比 较差异无统计学意义(P > 0.05)。结论 单次给予右美托咪定(0.5 μg/kg 和 1 μg/kg)对于七氟醚麻醉下行麦粒肿手术小儿早期 苏醒期躁动有预防作用,但在拔管时间方面 0.5 μg/kg 剂量优于 1 μg/kg。

关键词: 右美托咪定, 小儿, 七氟醚, 苏醒期躁动

Abstract: Objective To evaluate the efficacy and safety of dexmedetomidine for emergence agitation after hordeolum Incision in young children. Methods A total of 60 ASA physical status I and II young children,aged 1-3 years,underwent anesthesia for hordeolum Incision during December 2014 and March 2014,were randomly divided into 3 groups:Placebo group(NS group),the low dexmedetomidine concentration group(D0.5 group )and the high dexmedetomidine concentration group(D1.0 group ),with 20 cases in each group.The study was performed with informed consent and their families. All of the children received sevoflurane anesthesia induction and maintenance.After vein circuit connection,dexmedetomidine was given intravenously at a dose of 0.5 μg/kg or 1.0 μg/kg over a 10-min period via a computer controlled infusion pump.The heart rate and SpO2 were recorded for each patient in both operation room and PACU. The designated time points:at the start of the anesthetic induction,at the discontinuation of inhalational agents,at first breathing autonomously,and at time to remove endotracheal tube,were recorded. After patient arrived at the PACU,vital signs and the Cravero score were recorded every 10 minutes. Results The incidence of EA in group D1.0 and group D0.5 were lower than those in group NS at the time of extubation and 5 minutes later(P < 0.05).There was no significant difference between the group D1.0 and group D0.5(P > 0.05).There was no significant difference of the time of first breathing autonomously among three groups(P >0.05).The extubation time of group D1.0 was longer than that of group NS(P < 0.05),while no significant difference was found between group D0.5 and group NS(P > 0.05). Conclusion Administrating dexmedetomidine with doses of 1 μg /kg and 0.5 μg /kg both have preventive effect on EA in young children after hordeolum incision,and dexmedetomidine 0.5 μg /kg does not extend the time of extubation.

Key words: dexmedetomidine, pediatric, sevoflurane, emergence agitation

中图分类号: 

  • R614.2
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