右美托咪定用于小儿脸色苍白的原因与预防  

Reasons and Prevention of Dexmedetomidine for Pallor in Children

作　　者：周少武[1] 余霞[2] 李淑芬[1] 刘克超 刘宏强[1] 肖航[1] ZHOU Shaowu;YU Xia;LI Shufen;LIU Kechao;LIU Hongqiang;XIAO Hang(Department of Anesthesiology,Xiaogan Central Hospital,Hubei Province,Hubei Xiaogan 432000;Operating Room,Xiaogan City Central Hospital,Hubei Province,Hubei Xiaogan 432000)

机构地区：[1]湖北省孝感市中心医院麻醉科,湖北孝感432000 [2]湖北省孝感市中心医院手术室,湖北孝感432000

出　　处：《中国继续医学教育》2019年第8期90-92,共3页China Continuing Medical Education

摘　　要：目的寻求右美托咪定用于小儿出现脸色苍白的原因及预防措施。方法选择在全麻下行腹腔镜腹股沟斜疝疝囊高位结扎术的患儿40例作为研究对象,将其随机分为观察组和对照组,每组各20例。观察组在应用右美托咪定前肌注阿托品0.02 mg/kg,对照组无术前用药。两组患儿术前40分钟均行小容量分次含服右美托咪定2.5μg/kg术前镇静,记录每例患儿服药前T0,服药后30分钟T1,结扎疝囊时T2,拔管后5分钟T3,送麻醉恢复室后5分钟T4,各时间点的HR、SBP、RR、SpO2及有无脸色苍白的发生。结果观察组在T1、T2、T3、T4各时点的HR、SBP高于对照组,差异具有统计学意义(P <0.05或P <0.01);两组患儿SpO2、RR对比,差异无统计学意义(P> 0.05);观察组无患儿发生脸色苍白,对照组有8例发生脸色苍白,两组对比,差异具有统计学意义(P <0.01)。结论右美托咪定用于小儿出现脸色苍白的原因是右美托咪定的不良反应:导致小儿心率下降,预防措施为小儿应用右美托咪定前肌注阿托品0.02 mg/kg。Objective To seek reason and preventive measures of child’s turning pale after taking dexmedetomidine. Methods 40 children undergoing laparoscopic high ligation of indirect inguinal hernia sac under general anesthesia were randomly divided into observation group and control group, with 20 cases in each group. The observation group was given atropine 0.02 mg/kg before dexmedetomidine administration. The control group had no preoperative medication. Both groups were sedated with dexmedetomidine 2.5 μg/kg in small volume fractions 40 minutes before operation. T0 before administration, T1 30 minutes after administration, T2 at ligation of hernia sac, T3 5 minutes after extubation and T4 5 minutes after delivery to anesthesia recovery room were recorded. HR, SBP, RR, SpO2 and pallor occurred at all time points. Results HR and SBP of the observation group at T1, T2, T3 and T4 were higher than those of the control group, the difference was statistically significant (P < 0.05 or P < 0.01). There was no significant difference in SpO2, RR between the two groups (P > 0.05). There was no pallor in the observation group and 8 in the control group. The difference between the two groups was statistically significant (P < 0.01). Conclusion The cause of dexmedetomidine paleness in children is the adverse reaction of dexmedetomidine, which leads to the decrease of heart rate in children. The preventive measure is to inject 0.02 mg/kg of atropine into the anterior muscles of dexmedetomidine in children.

关 键 词：右美托咪定 小儿 不良反应 临床表现 原因分析 预防措施 

分 类 号：R726[医药卫生—儿科]