右美托咪定加小剂量氯胺酮在七氟烷麻醉小儿尿道下裂修补手术中的应用  

Application of Dexmedetomidine Plus Ketamine in Sevoflurane Anesthesian Children Undergoing Repair of Hypospadias

作　　者：唐珩[1] 袁野 刘星玲[1] TANG Heng;YUAN Ye;LIU Xing-ling(Department of Anesthesiology,the First People's Hospital of Yunnan,Kunming 650032,China)

机构地区：[1]云南省第一人民医院麻醉科,云南昆明650032

出　　处：《中国医药指南》2020年第15期35-36,共2页Guide of China Medicine

基　　金：云南省卫生科技计划项目(2017NS223)

摘　　要：目的探讨右美托咪定及小剂量氯胺酮复合七氟烷吸入麻醉在小儿尿道下裂修补手术中的临床效果。方法择期行尿道下裂修补手术患儿60例,随机分为两组,每组30例,S组采用七氟烷吸入麻醉,DK组采用右美托咪定及小剂量氯胺酮复合七氟烷吸入麻醉。观察并记录患儿4个不同时间点的心率(HR)、平均动脉压(MAP)、苏醒时间、拔管时间、PACU停留时间、躁动评分、PONV发生率及术后呼吸抑制的情况。结果麻醉诱导前(T0)两组患儿的心率、平均动脉压均差异无统计学意义(P>0.05),但气管拔管前(T1)、气管拔管后即刻(T2)、拔管后5 min(T3)S组患儿的心率、平均动脉压均显著高于同时间点DK组患儿,差异有统计学意义(P<0.05)。两组患儿苏醒时间、拔管时间没有统计学差异(P>0.05)。DK组患儿PACU停留时间明显长于S组(P<0.05)。DK组患儿苏醒期躁动发生率明显低于S组(P<0.05),两组患儿术后恶心呕吐发生率无统计学差异(P>0.05)。结论右美托咪定、小剂量氯胺酮复合七氟烷全身麻醉在小儿尿道下裂修补手术中应用,改善了患儿苏醒期躁动发生的情况,使患儿苏醒期更平顺且安全可行,值得临床应用推广。Objective To discuss the clinical effect of dexmedetomidine plusketaminein sevoflurane anesthesia in children undergoing repair of hypospadias.Methods 60 patients undergoing elective hypospadias surgery with general anesthesia werer andomly dividedintogroup Sand group DK,30 cases each.Sevoflurane alone was applied in group S,intravenous dexmedetomidine plus ketamine combined with inhalation of sevoflurane were applied in group DK.Four different time of HR,MAP,emergence time,extubation time,PACU residence time,the agitation score and adverse reaction suchas nausea and vomiting were observed and recorded.Results There was no difference in HR and MAP between the two groups at T0(P>0.05),however,compared with group DK,HR and MAP of group S at T1,T2 and T3 were higher,(P<0.05).There was no difference in emergence time and extubation time between the twogroups.Compared with group S,PACU residence time of group DK was longer and the incidence of agitation in group DK was lower,(P<0.05).There was no difference in other adverse reactions between the two groups(P>0.05)..Conclusion The application of dexmedetomidine and low-dose ketamine combined with sevoflurane in general anesthesia in children with hypospadias repair surgery improved the occurrence of restlessness in children during the recovery period,making the recovery period smoother,safer and more feasible for the children Promotion.

关 键 词：右美托咪定 芬太尼 尿道下裂修补术 

分 类 号：R614[医药卫生—麻醉学] R725.7[医药卫生—外科学]