右美托咪定治疗扁桃体切除术后患儿苏醒期躁动的临床效果观察  

Clinical evaluation on the effectiveness of dexmedetomidine on emergence agitation after tonsillectomy in children

作　　者：孟庆涛[1] 夏中元[1] 李维[1] 刘敏[1] 江莹[1] 唐玲华[1] 吴洋[1] 

机构地区：[1]武汉大学人民医院麻醉科,湖北武汉430060

出　　处：《热带医学杂志》2013年第8期985-988,共4页Journal of Tropical Medicine

摘　　要：目的评价右美托咪定治疗小儿扁桃体切除术后苏醒期躁动的有效性及安全性。方法将60名5～14岁拟行扁桃体切除术的儿童随机分为对照组、低剂量右美托咪定组及高剂量右美托咪定组。进入手术室前,受试儿童均接受微量泵静脉给予剂量为0.5μg/kg或1μg/kg的右美托咪定。所有患儿在手术室和PACU中均监测HR、SpO2及NIBP。同时记录麻醉诱导期开始、停止使用吸入麻醉药、第一次睁眼以及气管内导管拔除等几个特定时刻的时间。患儿送入PACU后,在最初的30min内,每5min记录VAS评分和RSS评分以及苏醒期躁动发生情况及其程度,而在拔管后的30min内,每10min记录上述结果。结果气管内导管拔除后,高剂量右美托咪定组与对照组比较,苏醒期躁动的发生率差异有统计学意义(P<0.05)。在拔管时以及其后的5min和10min,3组的VAS评分和RSS评分差异均具有统计学意义(P<0.05)。结论右美托咪定能安全有效地减少扁桃体切除术后患儿苏醒期的躁动,其治疗作用具有剂量依赖性。Objective To evaluate whether dexmedetomidine can be used safely to reduce the incidence of early emergence agitation in children after tonsillectomy.Methods 60 children,5 to 14 years old,undergoing anesthesia for tonsillectomy were randomly divided into 3 groups ：control group,the low dexmedetomidine concentration group and the high dexmedetomidine concentration group.Dexmedetomidine was given intravenously at a dose of 0.5μg/kg or 1 μg/kg over a 10-minute period via a computer controlled infusion pump.The HR,SpO 2 and NIBP were recorded in both OR and PACU.Several designated time points were recorded.After patient arrival at the PACU,VAS score,RSS,the occurrence of emergence agitation were recorded every 5 minutes for the first 30 minutes,and every 10 minutes for the next 30 minutes after endotracheal tube was removed.Results There was a significant difference in the incidence of EA between control group and the high concentration group after the removal of endotracheal tube （P ＆lt;0.05）.There was a significant difference in the VAS pain scores and in the RSS between the three groups at the time of extubation,as well as 5 minutes and 10 minutes after extubation （P＆lt;0.05）.Conclusion Dexmedetomidine appears to be safe and effective to reduce the incidence of early emergence agitation in children after tonsillectomy in a dose dependent manner.

关 键 词：右美托咪定 扁桃体切除术 七氟醚 

分 类 号：R614[医药卫生—麻醉学]