右美托咪定复合瑞芬太尼用于小儿纤维支气管镜检查的效果  

DEXMEDETOMIDINE COMBINED WITH REMIFENTANIL FOR CHILDREN UNDERGOING BRONCHOFIBROSCOPY

作　　者：倪欢欢[1] 杨玉玲[1] 何亮[1] 陈惠裕[1] 

机构地区：[1]南京医科大学第二附属医院麻醉科,江苏南京210011

出　　处：《齐鲁医学杂志》2016年第5期587-588,591,共3页Medical Journal of Qilu

摘　　要：目的观察右美托咪定复合瑞芬太尼在小儿纤维支气管镜检查中的麻醉效果。方法择期行纤维支气管镜检查的病儿60例,采用右美托咪定复合瑞芬太尼麻醉,记录病儿麻醉前(T0)、放镜时(T1)、检查结束退镜时(T2)、清醒时(T3)各时点平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO_2)的变化。监测病儿术中呼吸抑制、喉痉挛、术后恶心呕吐及术后烦躁等的发生情况。结果病儿均顺利完成检查,麻醉效果为优40例,良18例,可2例。3例病儿术中心率低于60min^(-1),给予阿托品后心率上升。未见病儿有喉痉挛、术后恶心呕吐及术后烦躁发生。与T0相比,60例病儿T1、T2及T3时点MAP和SpO2差异无显著性(P>0.05);与T0时点比较,HR在T1和T2时点明显降低(t=3.18、2.97,P<0.05)。结论右美托咪定复合瑞芬太尼用于小儿纤维支气管镜检查,能够提供较佳的镇静及镇痛效果,是一种安全高效的清醒镇静方法,值得临床推广应用。Objective To observe the effect of dexmedetomidine combined with remifentanil for children undergoing bronchofibroscopy. Methods Sixty sick children scheduled for bronchofibroscopy were enrolled.Combined Dexmedetomidine with remifentanil was used.The mean arterial pressure（MAP）,heart rate（HR）and SpO_2 before anesthesia（T0）,at inserting bronchofibroscope（T1）,at completion of examination and at withdrawing the endoscope（T2）and at awake（T3）were recorded.Respiratory depression and laryngeal spasm during examination,and nausea,vomiting and agitation after examination were monitored. Results All the patients smoothly completed the inspection.The anesthetic effectiveness was recorded as excellent in 40 patients,good in 18,and normal in two.The HR of〈60min^-1 was noted in three at examination,it rose after giving atropine.There were no laryngeal spasm,nausea and vomiting and agitation were noted during and after the examination.The differences in MAP and SpO2 among at T1,T2 and T3time points were not significant（P〉0.05）,and compared with T0 time point,HR at T1 and T2markedly lowered（t=3.18,2.97;P〈0.05）. Conclusion Dexmedetomidine plus remifentanil used in anesthesia for children undergoing bronchofibroscopy can provide a better sedation and analgesia,which is a safe and high-performance conscious sedation,and worthy of clinical application.

关 键 词：右美托咪定 瑞芬太尼 清醒镇静 支气管镜检查 儿童 

分 类 号：R614[医药卫生—麻醉学]