右美托咪定对小儿腹腔镜疝修补术后苏醒期躁动的影响  

Effects of single dose of dexmedetomidine on agitation following sevoflurane anesthesia in pediatric patient undergoing laparascopic herniorapphy

作　　者：Diwas Manandhar 叶西就[1] Roshni shah 许冬妮[1] 卢桠楠[1] 陈瑞霞[1] 

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,广州510120

出　　处：《岭南现代临床外科》2015年第6期700-703,共4页Lingnan Modern Clinics in Surgery

基　　金：国家自然科学基金(309722857)

摘　　要：目的研究给予单剂量右美托咪定对小儿腹腔镜疝修补术后苏醒期躁动的影响。方法60例行腹腔镜下疝修补术、ASA为Ⅰ-Ⅱ级、年龄为1~3岁的小儿。分为3组：在麻醉诱导后,D1组（n=20）静脉注射0.3μg/kg右美托咪定;D2组（n=20）静脉注射0.5μg/kg的右美托咪定;C组（n=20）注射相同容量的生理盐水。静脉注射时间均为10 min。麻醉诱导使用2000~4000μg/kg异丙酚及150~200μg/kg顺式阿曲库铵,1~1.5 MAC七氟醚和0.2μg·kg-1·min-1瑞芬太尼用于麻醉维持。麻醉诱导后所有小儿均静注2000μg/kg曲马多用于防治术后镇痛。结果 D2组术后躁动评分低于对照组（P〈0.05）,D1组与对照组无差别。右美托咪定组的心率低于对照组（P〈0.05）,其术后追加药物以加强镇静镇痛的需求也较低。三组的术后拔管时间比较无统计学意义。三组均未发生术后恶心、呕吐等不良反应。结论给予单剂量0.5μg/kg的右美托咪定可以有效减少行小儿腹腔镜疝修补术后苏醒期躁动的发生率,且无明显不良反应。Objective To investigate the effect of preoperative administration of single dose of demedetomidine on emergence agitation following sevoflurane anesthesia in small children undergoing laparoscopic hernia repair. Methods Sixty（ASA I-II, ageed 1-3 years） patients undergoing laparoscopic hernia repair, were assigned to three groups. Group D1（n=20） received Dexmedetomidine0.3 μg / kg iv immediately after induction over 10 mins. Group D2（n =20） received Dexmedetomidine0.5 μg / kg iv immediately after induction over 10 mins, whereas control group C（n =20） received equal volume of normal saline. Propofol（2000-4000 μg / kg） and cisatracurium（150-200 μg / kg）was used for induction and maintained. Results The agitation in the D2 group was lower than those in the control group. Mean Heart rate in dexmedetomidine group was found to be lower than in control group（P〈0.05）. Requirement of postoperative rescue drug was significantly lower in dexmedetomidine group. No significant difference was recorded in time to extubationin all three groups. Postoperative nausea and vomiting were not found in any subject in all the group. Conclusion Preoperative administration of 0.5 μg / kg of dexmedetomine is effective in reducing emergence agitation in small children following sevoflurane inhalation with no adverse effect.

关 键 词：右美托咪定 苏醒期躁动 小儿 

分 类 号：R614[医药卫生—麻醉学]