右美托咪定用于小儿唇腭裂手术麻醉的临床观察  

Clinical observation of dexmedetomidine in anesthesia of cleft lip and palate surgery

作　　者：董慧咏[1,2] 董振咏[1] 沈书斌[1] 张兆龙[1] 孟香果[1] 

机构地区：[1]石家庄市第一医院麻醉科,河北石家庄050011 [2]石家庄市第一医院药剂科,河北石家庄050011

出　　处：《中国美容整形外科杂志》2013年第7期425-428,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨右美托咪定用于小儿唇腭裂手术麻醉中的临床效果，为小儿唇腭裂手术麻醉安全用药提供依据。方法先天．性唇腭裂修复术患儿40例，随机分为右美托咪定组（D组）和对照组（C组）。两组患儿均采用紧闭面罩8％七氟烷吸入麻醉诱导，D组同时静脉泵注右美托咪定1μg/kg，C组给予同等容量生理盐水，均于10min给完。两组患儿均采用气管插管静吸复合全身麻醉方法，术中维持C组采用异丙酚-七氟烷复合麻醉；D组采用右美托咪定-异丙酚-七氟烷复合麻醉，观察并记录不同时点患儿心率、平均动脉压、脉搏血氧饱和度、呼气末二氧化碳分压并进行躁动评分，记录两组呼吸抑制及躁动发生率。结果两组患儿的手术时间、麻醉时间及苏醒时间差异无统计学意义（P〉0．05）。D组患儿在气管插管即刻（T2）、术中20min（T3）、术毕（T4）及拔管（T5）时平均动脉压和心率均明显低于C组（P〈0．05）。D组躁动发生率为11．1％，明显低于C组36．4％（P〈0．05）。D组无一例发生呼吸抑制。结论右美托咪定用于小儿唇腭裂修复术安全有效，术中血流动力学平稳，术后恢复期安静、舒适，能够减少围术期并发症的发生。Objective To investigate the clinical effect of Dexmedetomidine used in anesthesia of chil- dren cleft lip and palate cleft surgery in order to provide the base for safe drug use in clinical practice. Meth ods Forty children undergoing cleft lip and palate surgery were randomly divided into two groups： the Dexme- detomidine group （Group D） and the control group （Group C）, 8% Sevoflurane rapidlymask inhalation anaes- thesia induction in the two groups. The children in Group D pumped injection Dexmedetomidine （1μg/kg） during 10 minutes at the beginning of anesthesia induction; the children in Group C pumped injection the same dosage of physiological saline at the same way. Combined inhaled and intravenous general anesthesia with tra- cheal intubation was used in children in the two groups. Group C used propofol-sevoflurane combined anesthesia for the maintenance of anesthesia. Group D dexmedetomidine-propofol-sevoflurane combined anesthesia The children＇s heart rate, mean arterial pressure, pulse oxygen saturation, partial pressure of carbon dioxide in end- expiratory gas were observed and recorded. The degree of dysphoria was scored. The incidences of respiratory depression and dysphoria in the two groups were recorded. Results The heart rate and blood pressure of Group D were lower than those in Group C in intubation （T2） , surgery （T3）, end of surgery （T4） and extubation （ T5 ） （ P 〈 0.05 ）. The incidence of dysphoria in Group D after operation was 11.1% （2/18） and was significantly lower than that in Group C 36.4% （8/22）（P〈0.05）. No respiratory depression in Group D. Conclu sion Dexmedetomidine is safe and effective for anesthesia of cleft lip and palate in children, intraoperative he- modynamics is stable, postoperative recovery is quiet and comfortable, which makes perioperative complications reduced.

关 键 词：右美托咪定 小儿唇腭裂手术 麻醉 

分 类 号：R614[医药卫生—麻醉学]