右美托咪啶对小儿全麻诱导期不良反应的影响  

Effects of dexmedetomidine on adverse reaction to anesthesia induction in children

作　　者：余骏马[1,2] 张野[1] 陆姚[2] 董春山[2] 徐瑞好[2] 

机构地区：[1]安徽医科大学第二附属医院麻醉科,合肥230601 [2]安徽医科大学第三附属医院(合肥市第一人民医院)麻醉科,合肥230061

出　　处：《安徽医科大学学报》2014年第2期222-224,共3页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金青年项目(编号:81100105)

摘　　要：目的观察右美托咪啶对小儿全麻诱导期不良反应的影响。方法选择40例全麻下行择期外科手术的患儿,美国麻醉医师协会(ASA)分级Ⅰ级,随机数字表法分为2组(n=20):对照组(C组,泵注生理盐水0.15 ml/kg)、右美托咪啶组(D组,泵注右美托咪啶0.6μg/kg)。之后,静脉15 s注射咪达唑仑0.06 mg/kg,2 min后静脉注射丙泊酚2 mg/kg,1 min后静脉注射芬太尼2.5μg/kg。记录丙泊酚注射痛、芬太尼诱发呛咳的发生情况和强度,以及全麻诱导前(T0)、气管插管前(T1)和气管插管后(T2)的平均动脉压(MAP)和心率(HR)。结果 C组丙泊酚注射痛发生率为85%,D组无丙泊酚注射痛发生(P<0.01);两组患儿均无芬太尼诱发呛咳发生;与C组比较,T1时D组MAP升高,T2时D组MAP降低(P<0.01);与T0时比较,T1时C组MAP降低,T2时C组MAP、HR升高(P<0.01);与T1时比较,T2时C组MAP、HR均升高(P<0.01)。结论右美托咪啶复合咪达唑仑应用于小儿全麻诱导,无丙泊酚注射痛及芬太尼诱发呛咳发生,且患儿血流动力学稳定。Objective To evaluate the efficacy of dexmedetomidine on adverse reaction to anesthesia induction in children. Methods Forty ASA physical status class, undergoing elective surgery pediatric patients were random-ized into two groups of 20 each, using computer-generated random numbers. Group C：normal saline 0.15 ml/kg;Group D：dexmedetomidine 0. 6μg/kg. After aforementioned treatments in each group, midazolam 0.06 mg/kg by injection for 15 s;2 min later, all patients received propofol 2 mg/kg by injection over 20 s, then fentanyl 2.5μg/kg over 5 s. Another anesthesiologist, blind to the pre-treatment, recorded injection pain and fentanyl induced cough;in addition, mean arterial pressure （ MAP） and heart rate （ HR） before anesthesia （ T0 ） , before intubation （T1） and after intubation （T2） were recorded also. Results Seventeen （85%） patients in Group C （control） had pain, and none of patients in Group D had any injection pain （P＆lt;0.01）. However, there was no fentanyl in-duced cough in all patients. Hemodynamics of Group D were more stable than Group C （P＆lt;0.01）. ConclusionInjection pain of propofol and fentanyl induced cough can be completely supressed by pretreatment dexmedetomi-dine-midazolam during anesthesia induction in children, and the hemodynamic is stable.

关 键 词：丙泊酚注射痛 芬太尼诱发呛咳 血流动力学 右美托咪啶 全身麻醉 儿童 

分 类 号：R726.142[医药卫生—儿科]