艾贝宁用于学龄儿童扁桃体腺样体切除全麻中的观察  

The effect observation of dexmedetomidine in School-age pediatric patients

作　　者：张磊[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心麻醉科,430016

出　　处：《中国实用医药》2012年第16期13-15,共3页China Practical Medicine

摘　　要：目的艾贝宁(盐酸右美托咪定注射液),是新一代α2肾上腺素能受体激动剂,其通过高选择性激动α2肾上腺素能受体(α2∶α1=1620∶1),具有镇静、镇痛、抗交感而无呼吸抑制的作用,本文就其与安慰剂组相比,用于小儿扁桃体操、腺样体切除术中镇静镇痛抗焦虑进行对比,以观察临床效果。方法选择期全麻下行小儿扁桃体操、腺样体切除51例,ASAⅡ～Ⅲ级,年龄7～9岁,体重22～28 kg,并随机分为两组:艾贝宁组26例,安慰剂组25例。麻醉诱导气管插管前,一组外周静脉缓推艾贝宁0.5μg/kg(D组)(n=26),另一组外周静脉缓推盐水安慰剂(P组)(n=25)。60s注射完毕。分别持续记录术中患儿的呛咳次数,并记录患者的喉痉挛、支气管痉挛或氧和不足情况,气管插管前、中、后均记录患者血氧饱和度、心率、呼吸频率、收缩压和舒张压。还需记录麻醉苏醒时间。结果两组呛咳评分中位数分别为1(1～3)和2(1～4)(P<0.05)。但两组屏气或氧和不足发生率无差别。两组患者支气管镜操作时的心率、收缩压和舒张压有所上升(P<0.05),但艾贝宁组升高更不明显。两组患者麻醉苏醒时间基本相同。结论本研究发现单次静脉注射艾贝宁可减轻小儿气管插管时的气道和循环反射。Objective The alpha agonist dexmedetomidine, a sedative and analgesic,reduces heart rate and blood pressure dose-dependently. We investigated whether it also has the ability to attenuate airway and cir- culatory reflexes during emergence from anaesthesia. Methods Fifty one pediatric patients （7 - 9 years,22 - 28 kg） who undergoing plasma adenoid tonsil enucleation received a general anaesthetic. They were randomly al- located to either dexmedetomidine group（ group D, n = 26 ） or saline placebo group （ groupP, n = 25 ） intrave- nously （iv） over 60s in a double-blind design. The blinded anaesthetist awoke all the patients, and the number of coughs per patient was continuously monitored for 15 min after extubation;coughing was evaluated on a 4-point scale. Any laryngospasm, bronchospasm or desaturation was recorded. HR, SAP and DAP were measured before, during and after tracheal extubation. The time from tracheal extubation and emergenee from anaesthesia were re- corded. Results Median coughing scores were 1（1 ~3）in Group D and 2（1 -4） in Group P（P〈0. 05） ,but there were no differences between the groups in the ineidence of breath holding or desaturation. HR, SAP and DAP increased at extubation in both groups （ P 〈 O. 05 ）, but the increase was less significant with dexmedetomi- dine. The time from tracheal extubation and emergence from anaesthesia were similar in both groups. Conclu- sion These findings suggest that a single-dose bolus injection of dexmedetomidine before tracheal extubation at- tenuates airway-circulatory reflexes during extubation.

关 键 词：艾贝宁 学龄儿童 扁桃体腺样体摘除 

分 类 号：R726.1[医药卫生—儿科]