右美托咪定对小儿腹股沟斜疝手术的基础麻醉的影响  

Influence of dexmedetomidine on based anesthesia in undergoing unilateral inguinal hernia surgery infants

作　　者：吕金英[1] 刘莹[1] 邵军进[1] 

机构地区：[1]温州医学院附属东阳人民医院麻醉科,浙江省东阳322100

出　　处：《中国基层医药》2013年第7期1008-1010,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察右美托咪定（DEX）在小儿腹股沟斜疝手术镇静效果及对氯胺酮基础麻醉的不良反应的影响。方法80例行腹股沟斜疝修补手术的患儿采用咪达唑仑复合氯胺酮基础麻醉，然后按随机数字表法分为两组，对照组静脉注射0．9％氯化钠注射液，DEX组静脉注射0．5μg/kgDEX，用利多卡因骶管阻滞。观察患儿血流动力学、术中镇静程度、苏醒时间、苏醒期躁动评分，记录不良反应。结果两组血流动力学稳定，苏醒时间差异无统计学意义，镇静评分对照组（1．6±0．5）分大于DEX组（0．9±0．3）分（P〈0．05），苏醒期躁动评分对照组（1．52±0．54）分大于DEX组（0．51±0．48）分（P〈0．05），与DEX组比较，对照组出现6例严重躁动，12例精神症状，10例不自主肢体活动，8例恶心呕吐（P〈0．05）。结论结论0．5μg／kgDEX可以安全有效用于小儿麻醉，而且降低氯胺酮所引起的不良反应。Objective To study dexmedetomidine on the adverse impact of ketamine based anesthesia and sedative effects in indirect inguinal hernia. Methods Eighty children underwent indirect inguinal hernia surgery were randomily divided into two groups after injected muscle with midazolam and ketamine, Group B was injectded with 0.5 μg/kg DEX, but Group A with normal saline, analgesia was with caudal block （lidocaine）. The with hemodynam- ic,level of sedation, recovery time and CHW score were observed. The adverse reactions were recorded. Results Two groups of children have hemodynamically stable, and recovery time had no statistical significance. The two groups of CHW score in Group A （ 1.6 ± 0. 5 ） points higher than in group B （0. 9± 0.3 ） points （ P 〈 0.05 ）. The restlessness rated group （1.52 ±0..54） points was higher than in group B （0.51 ± 0.48） points （P 〈 0.05）. Compared with Group B, Group A had 12 cases of psychiatric symptoms, 10 cases of involuntary movement of limbs ,6 cases of severe postoperative agitation nausea, and 8 cases of vomiting （P 〈 0.05 ）. Conclusion 0.5μg/kg DEX can be safely and effectively used in the pediatric anesthesia, and reduce the adverse reactions caused by ketamine.

关 键 词：麻醉 右美托咪定 氯胺酮 疝 腹股沟 儿童 

分 类 号：R726.1[医药卫生—儿科]