右美托咪定联合氟比洛芬酯对小儿腹腔镜手术全麻苏醒期躁动的影响  

Dexmedetomidine combined with fexmedetomidine alleviates emergence agitation during recovery from pediatric laparoscopic surgery

作　　者：徐晶晶[1] 高宏[1] 王志萍[1] Xu Jingjing;Gao Hong;Wang Zhiping(Department of Anesthesia,People′s Hospital of Wuxi Affiliated to Nanjing Medical University, Wuxi214000,China)

机构地区：[1]南京医科大学附属无锡市人民医院麻醉科,214023

出　　处：《中华临床医师杂志（电子版）》2017年第13期1970-1973,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的观察右美托咪定联合氟比洛芬酯应用于小儿腹腔镜手术对全麻苏醒期的安全性和可行性。方法将2015年10月至2016年12月南京医科大学附属无锡市人民医院60例ASAⅠ级2~10岁在全麻下行小儿腹腔镜鞘状突高位结扎术和疝修补术的患儿,随机分为3组(n=20):氟比洛芬酯组(F组)、氟比洛芬酯联合右美托咪定组(FD组)、对照组(C组),麻醉诱导前分别静注1 mg/kg氟比洛芬酯、1 mg/kg氟比洛芬酯及0.5μg/kg右美托咪定、与F组等容量生理盐水。记录3组患儿拔管前(T_0)、拔管即刻(T_1)、拔管后5 min(T_2)各时点平均动脉压(MAP)、心率(HR)的变化,记录苏醒时间、拔管时间、拔管后呼吸道事件及苏醒期躁动发生情况。结果与C组比较,FD组在T_0、T_1、T_2时刻MAP和HR显著降低(P<0.01或P<0.05);与C组比较,F组在T_2时MAP和HR显著降低(P<0.01);与F组比较,FD组心率在MAP和HR下降(P<0.05)。与C组比较,FD组呼吸道事件和躁动发生率降低,差异有统计学意义(P<0.05)。结论麻醉诱导前联合应用氟比洛芬酯和右美托咪定可以有效减少小儿腹腔镜手术全麻苏醒期躁动,提高麻醉安全性,不延长患儿苏醒时间和拔管时间。Objective To observe the safety and feasibility of combined administration of dexmedetomidine with fexmedetomidine in alleviating emergence agitation during recovery from pediatric laparoscopic surgery.Methods Sixty2-10-year-old children who underwent high ligation of the processus vaginalis or herniorrhaphy at the People′s Hospital of Wuxi Affiliated to Nanjing Medical University from October2015to December2016were randomly divided into three groups(n=20each).Before anesthesia induction,the patients were intravenously injected with fexmedetomidine1mg/kg(group F),dexmedetomidine0.5μg/kg plus fexmedetomidine1mg/kg(group FD),or normal saline(group C).Mean arterial pressure(MAP)and heart rate(HR)were recorded before extubation(T0),at extubation(T1),and5min after extubation(T2).During the time course of recovery and extubation,respiratory events and psychomotor agitation were recorded.Results Compared with group C,MAP and HR at T0,T1,and T2ingroup FD,and MAP and HR at T2in group F were significantly decreased(P<0.05).Compared with group F,MAP and HR at T2in group FD were significantly decreased(P<0.05).The incidence rates of respiratory events and psychomotor agitation in group FD were significantly lower than those in other groups(P<0.05).Conclusion Dexmedetomidine combined with dexmedetomidine can effectively prevent psychomotoragitation during recovery from pediatric laparoscopic surgery and improve the security,without prolonging the recovery and extubation time.

关 键 词：右美托咪定 氟比洛芬酯 苏醒期躁动 儿童 

分 类 号：R726.1[医药卫生—儿科]