右美托咪定滴鼻对小儿七氟烷麻醉术前焦虑和术后躁动的影响  

Effects of intranasal dexmedetomidine as premedication on preoperative anxiety and emergence delirium after sevoflurane anesthesia in children

作　　者：高燕春[1] 谢言虎[1] 柴小青[1] 侯冠峰[1] 方才[1] 

机构地区：[1]安徽医科大学附属省立医院麻醉科,230001

出　　处：《江苏医药》2012年第7期831-833,共3页Jiangsu Medical Journal

摘　　要：目的观察右美托咪定(DM)滴鼻对小儿术前焦虑和术后躁动的影响。方法将60例1-4岁疝气手术小儿随机均分为三组。七氟烷麻醉诱导前30min,Ⅱ、Ⅲ组分别予以DM 0.5μg/kg和1μg/kg滴鼻,Ⅰ组滴生理盐水0.4ml对照。连续监测BP、HR、SpO2、PETCO2。观察患儿入室的镇静情绪评分、诱导时间、麻醉时间、苏醒时间、不良反应及术后患儿的躁动评分。结果Ⅲ组患儿术前镇静满意率明显高于Ⅰ组和Ⅱ组(45%vs.10%和15%)(P<0.05)。与Ⅰ组、Ⅱ组比较,Ⅲ组躁动评分和诱导时间明显降低(P<0.01)。三组间苏醒时间差异无统计学意义(P>0.05)。结论诱导前应用DM 1μg/kg滴鼻可有效改善小儿术前焦虑情绪,缩短七氟烷麻醉诱导时间,降低苏醒期躁动的发生率,且不延长苏醒时间。Objective To observe the effects of intranasal dexmedetomidine（DM） as premedication on preoperative anxiety and emergence delirium after sevoflurane anesthesia in children.Methods Sixty of 1-4 year-old children undergoing hernia surgery under sevoflurane anesthesia were equally randomized into tree groups of A（intranasal DM 0.5 μg/kg）,B（intranasal DM 1 μg/kg） and C（intranasal normal saline 0.4 ml）.Sevoflurane anesthesia was induced at 30 minutes after intranasal administration.BP,HR and SpO2 were monitored during the operation.The sadation scores,the times for induction,anesthesia and awaken,adverse reactions,agitation scores were recorded.Results The satisfaction rate for preanesthesia sedation was significantly higher in group B than that in groups of A and C（45% vs.10% and 15%）（P〈0.05）.The time for induction was shorter,and the agitation score was lower in group B than thaose in groups of A and C（P〈0.01）.There was no significant difference in the time for awakening among three groups（P〉0.05）.Conclusion Intranasal DM 1 μg/kg as premedication is effective for reducing anxiety and the incidence of emergence delirium without delaying the awakening time.

关 键 词：右美托咪定 焦虑 苏醒期躁动 七氟烷 小儿 

分 类 号：R614[医药卫生—麻醉学]