经鼻滴入右美托咪定对Ganz骨盆截骨术患儿术后苏醒期躁动的影响  

The effect of dexmedetomidine in an intranasal way to the emergence agitation of children undergoing Ganz osteotomy

作　　者：郑玫玫[1] 杜洪印[2] 韩世祺[3] 

机构地区：[1]天津医科大学,天津300070 [2]天津市第一中心医院麻醉科,天津300192 [3]天津市天津医院麻醉科,天津300211

出　　处：《临床和实验医学杂志》2015年第8期650-653,共4页Journal of Clinical and Experimental Medicine

基　　金：天津市卫生局科技基金攻关项目(13KG105)

摘　　要：目的观察经鼻滴入右美托咪定预防儿童全身麻醉苏醒期躁动的临床效果。方法选ASA分级I~Ⅱ级、在丙泊酚瑞芬太尼复合七氟醚静吸复合麻醉下行发育性髋关节脱位矫正术的12~14岁患儿60例。随机分为对照组和右美托咪定组各30例。在手术结束前30 min右美托咪定组给予1μg/kg右美托咪定滴鼻,对照组给予生理盐水0.01 ml/kg滴鼻。记录患儿苏醒即刻（T0）、苏醒5 min后（T1）、苏醒10 min后（T2）、苏醒30 min后（T3）的心率（HR）,以及拔管3 min（T4）、拔管5 min（T5）、拔管10 min（T6）的血氧饱和度（Sp O2）以及拔管10 min时Aono躁动评分和儿童麻醉苏醒谵妄PAED评分及躁动发生率。结果右美托咪定组Aono评分、PAED评分及躁动发生率均显著低于对照组（P〈0.05）。两组患儿苏醒时各时间点Sp O2、HR均无统计学差异（P〉0.05）。所有患儿在麻醉手术过程中均无呕吐、喉痉挛、误吸等不良反应发生。结论手术结束前30 min经鼻给予1μg/kg右美托咪定可以明显减少手术患儿全麻苏醒期躁动的发生,是临床上预防苏醒期躁动的一个行之有效且安全的给药方法。Objective This study was designed to observe the use of intranasally administered dexmedetomidine（ Dex） as an intraoperative dosing method on emergence agitation in children after general anesthesia. Methods Sixty children of American Society of Anesthesiology classification（ ASA） physical status（ I II）,aged 12- 14 years,treating DDH under general anesthesia,were randomly assigned to one of twoequal groups. Dex 1μg / kg and 0. 9% saline 0. 01 ml / kg was given by intranasally administered at 30 min before the end of surgery. Heart rate（ HR） was observed and recorded at wake- up after anesthesia（ T0）,5 min after wake- up（ T1）,10 min after wake- up（ T2）,30 min after wake- up（ T3）,Oxygen saturatio（ Sp O2） were also observed and recorded at 3 min after tracheal extubation（ T4）,5 min after tracheal extubation（ T5）,10 min after tracheal extubation（ T6）. Aono scores,PAED scores and the incidence of agitation were also recorded 10 min after extubation. Results Aono scores,PAED scores and the incidence of agitation were significantly lower in group D compared group S（ P〈0. 05）.There was no obviously difference on HR MAP and Sp O2 between two group of children（ P〉0. 05）. And no incidence of vomiting,laryngospasm and aspiration was observed in either of the group during the study. Conclusion Intranasal dexmedetomidine（ 1 μg / kg） at 30 min before the end of surgery can reduce the incidence of emergence agitation in children and it is an effective and safe alternative for preventing emergence agitation.

关 键 词：儿童 全身麻醉 苏醒期躁动 右美托咪定 

分 类 号：R726.1[医药卫生—儿科]