右美托咪定复合七氟烷全麻对小儿喉乳头状瘤切除术麻醉苏醒期躁动的影响  

Effect of dexmedetomidine combined with sevoflurane general anesthesia on the emergence agitation in pediatric laryngeal papilloma surgery

作　　者：汤荣兴[1] 王晓军[1] 徐连生[1] Tang Rongxing;Wang Xiaojun;Xu Liansheng(Department of Anesthesiology,The First People＇s Hospital of Yibin,Sichuan Yibin 644000,China)

机构地区：[1]宜宾市第一人民医院麻醉科,四川宜宾644000

出　　处：《现代肿瘤医学》2018年第18期2938-2941,共4页Journal of Modern Oncology

基　　金：宜宾市卫生局科学技术基金资助项目(编号:[2014]350号)

摘　　要：目的:探讨右美托咪定复合七氟烷全麻对小儿喉乳头状瘤切除术麻醉苏醒期躁动的影响。方法:选取行喉乳头状瘤切除术患儿60例为研究对象,根据随机数字表法将其分为观察组和对照组,各30例。观察组术前予以右美托咪定1μg/kg稀释成10 ml在10分钟内泵注完;对照组予以10 ml生理盐水10分钟内泵注完。入室后两组均予以面罩8%七氟烷+高流量氧气(6 L/min)麻醉诱导,保持自主呼吸气管插管,患儿仰卧行喉乳头状瘤切除术,术中3%~4%七氟烷维持麻醉。记录诱导前镇静评分和诱导前(T_0)、插管前(T_1)、插管后(T_2)、手术开始(T_3)、手术结束(T_4)、清醒拔管(T_5)各时间点的MAP、HR、BIS;记录两组苏醒时间、清醒拔管后5 min(T_6)及拔管后10 min(T_7)的躁动评分。结果:观察组诱导前镇静满意率高于对照组(P<0.05);观察组各时间点的MAP、HR、BIS均低于对照组(P<0.05);两组苏醒时间比较差异无统计学意义(P>0.05);观察组清醒拔管后躁动评分低于对照组(P<0.05)。结论:右美托咪定复合七氟烷全麻应用于小儿喉乳头状瘤切除术可提高麻醉手术的安全性和有效防止患儿苏醒期躁动。Objective： To expiore the effect of dexmedetomidine combined with sevoflurane general anesthesia on the emergence agitation in pediatric laryngeal papilloma surgery.Methods： 60 children with laryngeal papilloma resection were selected as the subjects.According to the random number table method,they were divided into the observation group and the control group,each with 30 cases.The observation group received dexmedetomidine,1 μg/kg diluted into 10 ml injected within 10 minutes.The control group with 10 ml normal saline were injected within 10 miutes.After admission two groups of children were induced anesthesia by mask 8% seven fluorane ＋ high flow oxygen（ 6 L/min）,to maintain spontaneous breathing with airway of intubation,children with supine laryngeal papilloma resection,intraoperative 3% ~ 4% sevoflurane maintenance anesthesia.To record the sedation scores before anesthsia induction and the dates of MAP,HR,BIS at the moment before induction（ T_0）,before intubation（ T_1）,after intubation（ T_2）,before operation（ T_3）,after operation（ T_4） and awake by out of intubation（ T_5）.To record the time of awake,and the agitation scores at 5 minutes awake（ T_6） and 10 minutes awake（ T_7）.Results： The satisfaction rate of sedation before induction in the observation group was higher than that in the control group（ P 0.05）.The MAP,HR and BIS at different time point in the observation group were lower than those in the control group（ P 0.05）.There was no significant difference in awakening time between the two groups（ P 0.05）.The agitation score after sober extubation of the observation group was lower than that of the control group（ P 0.05）.Conclusion： Dexmedetomidine combined with sevoflurane general anesthesia was used in pediatric laryngeal papilloma surgery,which can improve the safety of anesthesia and prevent emergence agitation.

关 键 词：喉乳头状瘤 右美托咪定 七氟烷 苏醒期躁动 小儿 

分 类 号：R739.65[医药卫生—肿瘤]