不同剂量右美托咪定对儿童颅脑术后苏醒期躁动的影响  

Effects of different doses of dexmedetomidine on postoperative agitation in children receiving craniotomy

作　　者：马佳佳[1] 岳红丽[1] 王德祥[1] 金旭[1] 韩如泉[1] Ma Jiajia;Yue Hongli;Wang Dexiang;Jin Xu;Han Ruquan(Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,北京100070

出　　处：《首都医科大学学报》2021年第3期459-463,共5页Journal of Capital Medical University

基　　金：北京市东城区优秀人才培养资助项目(2019DCT-M-17)。

摘　　要：目的探讨不同剂量右美托咪定(dexmedetomidine,DEX)对儿童颅脑术后苏醒期躁动的影响。方法选取择期行颅脑手术的患儿120例,年龄3~14岁,根据DEX使用剂量采用随机数字表法分为4组:低剂量组、中剂量组、高剂量组、0.9%(质量分数)氯化钠注射液(以下简称生理盐水)对照组,每组30例,手术结束前分别以0.4、0.6、0.8μg·kg-1·h^(-1)DEX或生理盐水维持1 h至手术结束。观察主要结局指标为患儿苏醒期躁动发生率。次要结局指标为苏醒时间、拔管期呛咳发生率等。结果中、高剂量组躁动发生率明显降低(17%,11%vs 64%,P<0.01);且剂量依赖性地降低拔管时呛咳发生率(P<0.01)。高剂量组苏醒时间显著延长(P<0.01)。结论0.6μg·kg^(-1)·h^(-1)右美托咪定可以显著减少儿童颅脑术后苏醒期躁动和呛咳发生率,且镇静程度更适宜。Objective To investigate the effect of different doses of dexmedetomidine(DEX)on postoperative agitation in children receiving craniotomy.Methods Total 120 children aged 3-14 years old receiving elective craniotomy were enrolled and divided into four groups according to the dosage of dexmedetomidine:low-dose group(0.4μg·kg^(-1)·h^(-1)),medium dose group(0.6μg·kg^(-1)·h^(-1)),high-dose group(0.8μg·kg^(-1)·h^(-1))and normal saline control group,with 30 cases in each group.Primary outcome indexes were based on the incidence of agitation after the craniotomy.Secondary outcomes indexes were based on recovery time and the incidence of choking.Results The incidences of agitation in the middle dose group and the high dose group were significantly lower(17%,11%vs 64%,P<0.01).The incidences of choking during extubation were reduced in a dose-dependent manner(P<0.01).The recovery time after drug withdrawal was significantly longer in the high-dose group(P<0.01).Conclusion Infusion of dexmedetomidine at the concentration of 0.6μg·kg^(-1)·h^(-1)at the end of operation significantly reduces the incidence of agitation and choking after craniotomy in children,and the degree of sedation was more appropriate.

关 键 词：右美托咪定 儿童 颅脑手术 苏醒期 躁动 

分 类 号：R614[医药卫生—麻醉学]