右美托咪定和咪达唑仑对七氟烷麻醉患儿术后躁动影响的比较  

Comparison of Effects of Dexmedetomidine and Midazolam on Sevoflurane-related Emergence Agitation in Children

作　　者：徐鸣 郑艳萍 周斌[2] 

机构地区：[1]南昌市第三医院麻醉科,南昌330009 [2]南昌大学第二附属医院麻醉科,南昌330006

出　　处：《南昌大学学报（医学版）》2014年第3期52-54,共3页Journal of Nanchang University：Medical Sciences

摘　　要：目的：比较右美托咪定和咪达唑仑对七氟烷麻醉斜视患儿术后躁动的影响。方法将60例年龄为3～10岁、ASAⅠ-Ⅱ级接受斜视矫正手术的儿童按随机数字表法分为生理盐水组（C 组）、右美托咪定组（D 组）以及咪达唑仑组（M 组），每组20例。3组麻醉均采用七氟烷诱导及维持，手术结束前10 min，D 组静脉推注右美托咪定0．5μg·kg-1，M 组静脉推注咪达唑仑0．05 mg·kg-1，C 组静脉推注相同容量的生理盐水。在围拔管期，记录3组拔管所需时间以及 PACU 停留时间；并采用 Watcha 评分及 PAED 评分评定3组患儿术后躁动情况。结果与C 组相比，D 组和 M 组的苏醒期评分均显著降低（P ＜0．05），拔管时间均显著延长（P ＜0．05）；与 D 组相比，M 组的苏醒期评分显著增加（P ＜0．05），PACU 停留时间显著延长（P ＜0．05）；而 C 组与 D 组的 PACU 停留时间相比差异无统计学意义（P ＞0．05），D 组与 M 组的拔管时间相比差异无统计学意义（P ＞0．05）。结论手术结束前10 mim静脉给与右美托咪定0．5μg·kg-1比咪达唑仑0．05 mg·kg-1更能减轻七氟烷全身麻醉下小儿术后烦躁，且不延长 PACU 停留时间。Objective To compare the effects of dexmedetomidine and midazolam on sevoflu-rane-related emergence agitation in children.Methods Sixty ASAⅠ-Ⅱchildren aged 3 to 10 years who received strabismus surgery were randomly divided into normal saline group （group C）, dexmedetomidine group（group D）and midazolam group （group M）,with 20 children in each group.The sevoflurane was used for anesthesia induction and maintenance in all patients.In addi-tion,group C,D and M were intravenously injected with the same volume of normal saline, dexmedetomidine（0.5 μg·kg-1 ）and midazolam（0.05 mg·kg-1 ）10 minutes before the end of surgery,respectively.The time to extubation and duration of PACU stay were recorded in the periextubation period.Postoperative emergence agitation was assessed with the Watcha and PAED scales.Results Compared with group C,emergence agitation score decreased and extuba-tion time increased in group D and group M（P 〈0.05）.Compared with group D,emergence agita-tion score and duration of PACU stay increased in group M（P 〈0.05）.There were no significant differences in the duration of PACU stay between group C and group D,as well as in the time to extubation between group D and group M（P 〈0.05）.Conclusion Dexmedetomidine（0.5 μg· kg-1 ）administered 10 minutes before the end of surgery is superior to midazolam（0.05 mg· kg-1 ）for reducing sevoflurane-related emergence agitation and duration of PACU stay.

关 键 词：右美托咪定 七氟烷 咪达唑仑 苏醒期烦躁 

分 类 号：R614[医药卫生—麻醉学]