右美托咪定和丙泊酚复合球后神经阻滞麻醉在儿童斜视手术中镇静效应的对比研究  

Comparison of the sedative effects of Dexmedetomidine and Propofol retrobulbar nerve block anes- thesia in children strabismus surgery

作　　者：田丹丹[1] 任燕伶[1] 付琦[1] 张卫[1] 艾艳秋[1] 

机构地区：[1]郑州大学第一附属医院麻醉科河南省高等学校临床医学重点学科开放实验室,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2012年第11期833-836,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：国家自然科学基金[项目编号：（81171060/H0903）]

摘　　要：目的探讨右美托咪定和丙泊酚复合球后神经阻滞麻醉在儿童斜视手术中的镇静效果。方法60例7～12岁单侧斜视矫正手术患儿，随机分为右美托咪定组（D组）和丙泊酚组（P组），每组30例。球后阻滞前10min开始静脉泵注药物，右美托咪定0．3～0．4μg·kg-1·h-1和丙泊酚100—150μg·kg-1·min-1。记录两组患儿麻醉前（T0）、球后阻滞麻醉完毕即刻（T1）、手术开始后10min（T2）、20min（T3）、30min（T4）、手术结束（T5）的平均动脉压（MAP）、心率（HR）、脉搏血氧饱和度（SPO2）、语言描述评分（VRS）及改良清醒镇静评分（OAA／S）及呼吸抑制情况。结果T1～T5时D组和P组的OAA／S评分低于T0时（P〈0．05）；T1～T5时D组HR慢于R时和P组（P〈0．05）；两组OAA／S、VRS、MAP、SPO2比较差异无统计学意义（P〉0．05），P组1例出现舌后坠，4例出现注射痛、2例发生恶心呕吐和1例出现心动过缓等不良反应。结论右美托咪定和丙泊酚复合球后神经阻滞麻醉均能为儿童斜视手术提供良好的镇静效果，而右美托咪定与丙泊酚比较不良反应发生率低，更安全有效。Objective To Compare the sedative effects of Dexmedetomidine and Propofol retrobul- bar nerve block anesthesia in children strabismus surgery. Methods Sixty children patients, ASA （Ameri- can Society of Anesthesiologist） degree Ⅰ-Ⅱ , aged 7 to 12 years, were scheduled for strabismus surgery. They were equally randomized divided into two groups, group D （ Dexmedetomidine with retrobulbar nerve block） and group P （Propofol with retrobulbar nerve block）. We start retrobulbar nerve block 10 rains after sedative administration. Median artery pressure（MAP） ,Heart rate（HR） ,Pulse Oxygen saturation （ SpO2 ） , Verbal rating scale（VRS） and observer＇ s assessment of alertness/sedation scale （OAA/S） were recorded before anesthesia（ To ） ,right after retrobulbar nerve block（ T1 ） ,and 10（ T2 ） ,20（ T3 ） ,30 min（ T4 ） after ret- robulbar nerve block and after the surgey（ T5 ）. Results OAA/S scores were lower at T1 - T5 than at TO in group D and group P（P 〈 0.05 ）. Heart rate was slower in group D than that in group P at T1 - T5 （ P 〈 0.05）. There was no significant change in OAA/S, VRS, MAP and SpO2 between the two groups （ P 〉 0. 05）. In the group P,1 patient appeared glossocoma,4 eases with injection pain,2 cases with nausea and vomiting and 1 case with bradyeardia. Conclusion Dexmedetomidine and Propofol compounding retrobul- bar nerve block anesthesia were all practicable in children strabismus surgery, but Dexmedetomidine given a low incidence of adverse reaction compared with Propofol.

关 键 词：右美托咪定 丙泊酚 球后神经阻滞麻醉 镇静效应 

分 类 号：R614[医药卫生—麻醉学]