右美托咪定预防小儿眼科手术苏醒期躁动  

Dexmedetomidine infusion for prevention of emergence agitation from anesthesia in pediatric oph- thalmic surgery

作　　者：张斯[1] 付琦[1] 康鑫鑫[1] 王元[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,450052

出　　处：《中华眼外伤职业眼病杂志》2014年第4期294-297,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨右美托咪定用于小儿眼科手术以预防静脉麻醉苏醒期躁动的效果及安全性。方法小儿眼外伤手术60例。随机分为两组：右美托咪定组（A组）和对照组（B组），每组30例。A组：0．5μg／kg的右美托咪定用生理盐水稀释至20ml，于麻醉诱导前用微量泵10min内注射完毕，B组：于相同时间注射等量生理盐水。观察两组注射前（T0）、注射后5min（T1）、清醒时（T2）、拔管后5min（T3）、拔管后10min（T4）的平均动脉压、心率、脉搏血氧饱和度，及全麻苏醒期躁动评分和躁动率之间的差异。结果两组患儿性别、年龄、体重、手术时间及各时间点血氧饱和度比较差异无统计学意义（χ2=0．082，t=0．398，0．296，0．765，P〉0．05）；与B组相比，A组T1时的HR，T2、T3及T4时的平均动脉压、心率及烦躁发生率均有明显的降低，差异有统计学意义（t=5．651，12．438，10．928，14．247，13．819，17．717，15．141，2．321，8．797，8．797，χ2=5．963，8．365，6．667，P〈0．05）。结论麻醉诱导前10min内静脉输注0．5μg/kg右美托咪定，可安全有效地降低眼科手术患儿全麻苏醒期躁动的发生。Objective To investigate the security and effectiveness of dexmedetomidine infusion for prevention of emergence agitation from intravenous anesthesia in ophthalmic surgery. Methods 60 opera- tions of pediatric ocular trauma were randomly divided into two groups ： The dexmedetomidine group （ group A, n = 30） and the control group（group B, n = 30））. When anesthesia induction was administrated, nor- mal saline 20 ml or dexmedetomidine 0.5 μg/kg diluted to 20 ml was intravenously infused in 10 minutes. The difference between the mean artery pressure（MAP） , heart rate（HR） and SpO2 before injection（ T0）, 5 minutes after injection（ T1 ）, awakening（ T2）, 5 minutes after extubation（ T3 ）, 10 minutes after extubation （T4） and the agitation scale were observed in two groups. Results There was no significant difference be- tween the two groups in sex, age, weight, time of operation and SpO2 in TO to T4 （χ2 = 0. 082, t = 0. 398, 0. 296,0. 765,P 〉 0.05 ）. Compared with group B, the HR of T1, the MAP, HR and agitation scale of T2, T3 and T4 were lower in group A （t =5. 651,12. 438,10. 928,14. 247,13. 819,17. 717,15. 141,2. 321, 8. 797,8. 797 ,χ2 = 5. 963,8. 365,6. 667,P 〈 0.05） in two groups. Conclusion Dexmedetomidine of 0.5 μg/kg was intravenously infused 10 min before anesthesia induction can safely and effectively reduce the oc- currence of emergence agitation from anesthesia in pediatric ophthalmic surgery.

关 键 词：右美托咪定 手术 眼科 麻醉 静脉 躁动 苏醒期 

分 类 号：R726.1[医药卫生—儿科]