右美托咪定复合硬膜外麻醉在儿童腹股沟疝修补术中的应用  

The application of dexmedetomidine/ropivacaine epidural anesthesia for children with inguinal hernia repair surgery

作　　者：刘国栋[1] 欧阳辉旺[1] 于春宇[1] 谢威[1] 王正坤[1] 武建[1] LIU Guo-dong;OUYANG Hui-wang;YU Chun-yu;XIE Wei;WANG Zheng-kun;WU Jian(Department of Anesthesiology, Foshan Maternal and Child Health Hospital, Foshan 528000, Guangdong, China)

机构地区：[1]佛山市妇幼保健院麻醉科,广东佛山528000

出　　处：《广东医学》2019年第6期795-798,共4页Guangdong Medical Journal

基　　金：佛山市自筹经费类科技计划项目(编号:2017AB002881)

摘　　要：目的观察右美托咪定复合罗哌卡因硬膜外给药在小儿腹股沟疝修补术中的麻醉效果。方法选取儿童腹股沟疝112例,采取随机数字表法分为两组,右美托咪定复合罗哌卡因组(观察组,56例)和罗哌卡因组(对照组,56例)。记录两组患儿麻醉前后平均动脉压(MAP)、心率(HR)、呼吸频率(RR)和血氧饱和度(SpO_2),比较两组硬膜外阻滞起效时间、Ramsay镇静评分和术中牵拉反应程度,对比两组术后恶心、呕吐、寒战、神经系统症状及术后感染发生情况。结果两组麻醉前后MAP、HR、RR和SpO_2差异无统计学意义(P>0.05);与对照组比较,观察组硬膜外阻滞起效时间明显缩短、Ramsay镇静评分显著降低,差异有统计学意义(P<0.05);观察组术中牵拉反应程度轻,术后恶心、呕吐等不良并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定在儿童腹股沟疝修补手术中的应用安全有效,可增强硬膜外麻醉的效果并减少不良反应,值得临床应用。Objective To investigate the anesthetic efficacy of dexmedetomidine/ropivacaine combined epidural anesthesia for children with inguinal hernia repair surgery.Methods A total of 112 children with inguinal hernia were enrolled and randomized into dexmedetomidine/ropivacaine group(Group DR) and dexmedetomidine group(Group R). The data of MAP, HR, SpO2, anesthetic effect time, Ramsay score and traction responses were collected. The nausea, vomiting, chill, nervous system symptoms and postoperative infections between two groups were compared. Results There were no significant difference in MAP, HR, RR or SpO2 between the two groups(P>0.05). Compared with Group R, the anesthetic effect times were significantly shorter and lower Ramsay score than Group DR(P<0.05). The nausea, vomiting, chill, nervous system symptoms and postoperative infections were significantly improved in Group DR comparing with Group R(P<0.05). Conclusion Dexmedetomidine administration is safe and effective in child inguinal hernia repair surgery. It can enhance the anesthetic effects in epidural anesthesia, reduce the adverse reactions.

关 键 词：右美托咪定 硬膜外麻醉 复合麻醉 儿童腹股沟疝 

分 类 号：R614.42[医药卫生—麻醉学] R656.21[医药卫生—外科学]