右旋美托咪啶在预防幼儿七氟醚麻醉苏醒期躁动的应用  

Role of dexmedetomidine in prevention of agitation during recovery from pediatric anesthesia with sevolurane

作　　者：苏丹晨[1] 黄希照[1] 黄伟坚[1] 李顺荣[1] 

机构地区：[1]广东省妇幼保健院麻醉科, 广州510000

出　　处：《国际医药卫生导报》2013年第5期595-598,共4页International Medicine and Health Guidance News

基　　金：广东省医学科研基金资助项目（B2012028）

摘　　要：目的采用随机双盲的方法观察不同剂量右旋美托咪啶对预防幼儿七氟醚麻醉苏醒期躁动的效果及镇静程度。方法选择择期行唇裂修补术的患儿60例，年龄1～3岁，ASAI级，将其随机分为小剂量右旋美托咪啶组（D1）、中等剂量右旋美托咪啶组（D2）及对照组（C），每组20例。各组患儿以单纯七氟醚诱导插管，D1、D2组分别于气管插管后静脉注射右旋美托咪啶0．2μg，kg、0．4斗∥kg，注射时间〉10rain，C组静脉注射生理盐水，术中吸入七氟醚维持麻醉深度于Nacrotrend值D水平，术毕待患儿呼吸恢复，保护性发射恢复时拔管。结果三组患者苏醒时间、拔管时间、脉搏氧饱和度（SpO2）均无显著差异（P〉0．05）。D1、D2组拔管时和拔管后10min患儿心率（HR）和平均动脉压（MAP）均比c组明显下降。术后躁动发生率，D。组为26．7％，D：组为6．7％，c组为33．3％，组问比较差异有统计学意义（P〈0．05）。D：组患儿清醒镇静程度评分比D。组更高（P〈O．01）。三组均未出现严重并发症。结论右旋美托咪可以有效预防幼儿七氟醚麻醉苏醒期躁动。Objective To explore the effect of preemptive analgesia with different doses of dexmedetomidine on postoperative agitation, blatbada Sixty ASA I children undergoing cheiloplasty were randomly divided into low-dose dexmedetomidine group （group D1, n = 20）, moderate-dose dexmedetomidine group （group D2, n = 20）, and control group （group C, n = 20）. Anesthesia was induced with sevoflurane for tracheal intubation. In groups D1 and D2, 0.2 tx g/kg and 0.4 Ix g/kg dexmedetominde were administered intravenously after intubation, and in group C, normal saline was administered. Anesthesia was maintained with uses of sevoflurane. Rasults There were no significant differences in time to consciousness recovery, extubation time, and pulse oxygen saturation （SpO2） among the three groups （P〉0.05）. As compared with group C, heart rate and mean arterial pressure were significantly decreased during extubation and 10 min after extubation in group DI and D2. The incidence of postoperative agitation was decreased significantly, and sedation extent was increased significantly in group D2 （/9〈0.01）. Conchmiom Dexmedetominde can effectively prevent postoperative agitation during consciousness recovery in children receiving inhalational sevoflurane.

关 键 词：右旋美托咪啶 七氟醚麻醉 麻醉苏醒期躁动 1—3岁幼儿 

分 类 号：R726.1[医药卫生—儿科]