盐酸右美托咪定在小儿体外循环心内直视手术快通道麻醉中的应用  

Application of dexmedetomidine hydrochloride in fast-track anesthesia during open heart surgery of children with cardiopulmonary bypass

作　　者：曾智琴 王凯 ZENG Zhiqin;WANG Kai(Department of Anesthesiology,the First People's Hospital of Chenzhou City,Hunan Province,Chenzhou 423000,China)

机构地区：[1]湖南省郴州市第一人民医院麻醉科,423000

出　　处：《临床合理用药杂志》2021年第29期7-9,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察盐酸右美托咪定在小儿体外循环(CPB)心内直视手术快通道麻醉中的应用效果。方法 选取2019年7月-2020年6月郴州市第一人民医院收治的行小儿体外循环心内直视手术治疗的先天性心脏病患儿60例为研究对象,按照随机数字表法分为观察组和对照组,各30例。观察组在快速通道麻醉中应用盐酸右美托咪定,对照组则应用等容量生理盐水,比较2组患者不同时间点心率、收缩压、舒张压,麻醉药物使用剂量及呼吸机使用时间、住院时间。结果 观察组患儿各时间点[给药后10 min(T_(1))、切皮后(T_(2))、锯胸骨后5 min(T_(3))、CPB后(T_(4))和拔管后(T_(5))]心率、收缩压、舒张压均显著低于对照组(P <0. 01);观察组患儿舒芬太尼、罗库溴铵使用量均少于对照组(P <0. 01);观察组患儿呼吸机使用时间和住院时间均明显短于对照组(P <0. 01)。结论 盐酸右美托咪定有利于小儿CPB心内直视手术快通道麻醉的实施,其能够降低患儿的心率和舒张压,同时能够显著减少麻醉药物的使用量,帮助患儿获得更好的治疗效果,从而有效促进患儿早期康复,值得临床推广应用。Objective To study the effect of dexmedetomidine hydrochloride in fast-track anesthesia during open heart surgery of children with cardiopulmonary bypass. Methods 60 children with congenital heart disease who underwent pediatric cardiopulmonary bypass and open heart surgery were treated in the First People’s Hospital of Chenzhou City from July2019 to June 2020. They were randomly divided into observation group and control group,with 30 cases in each group. The observation group used dexmedetomidine hydrochloride in fast-track anesthesia,and the control group used equal volume normal saline. The heart rate,systolic blood pressure,diastolic blood pressure,as well as the dosage of anesthetics and the use of ventilator were compared between the two groups at different time points. Indicators such as length of time and length of hospital stay. Results Observation group children at various time points[10 min after administration( T1),after skin incision( T2),5 min after sawing the breastbone( T3),after CPB( T4) and after extubation( T5) ]heart rate,systolic blood pressure,diastolic blood pressure were significantly lower than those in the control group( P < 0. 01). The dosages of fentanyl and rocuronium in the observation group were significantly lower than those of the control group( P < 0. 01). The ventilator use time and hospital stay of the children in the observation group were significantly shorter than those in the control group( P < 0. 01).Conclusion Dexmedetomidine hydrochloride is beneficial to the implementation of fast-track anesthesia during open heart surgery of children with cardiopulmonary bypass,it can reduce the patient’s heart rate and diastolic blood pressure,and can significantly reduce the amount of anesthetics used,thereby effectively promoting the early recovery of patients,to help patients obtain better treatment results,it is worthy of clinical application.

关 键 词：小儿体外循环心内直视手术 盐酸右美托咪定 应用效果 

分 类 号：R726.1[医药卫生—儿科]