右美托咪定对手术患儿麻醉时血流动力学指标及苏醒期躁动的影响  

The Effect of Dexmedetomidine on Hemodynamic Indexes and Restlessness during Awakening in Children Undergoing Anesthesia during Operation

作　　者：韩殿伟 王菲 HAN Dianwei;WANG Fei(Department of Surgical Anesthesiology,the Third Staff Hospital of Baotou Steel Group,Baotou,Inner Mongolia Autonomous Region,014010 China)

机构地区：[1]包钢集团第三职工医院手术麻醉科,内蒙古包头014010

出　　处：《系统医学》2021年第18期65-67,共3页Systems Medicine

摘　　要：目的探讨右美托咪定对手术患儿麻醉时血流动力学指标及苏醒期躁动的影响。方法选取2018年1月—2020年6月该院收治的60例急性阑尾炎患儿,以随机数字表法分为对照组与研究组,各30例。两组均在全麻下实施腹腔镜阑尾切除术,研究组应用右美托咪定复合七氟醚麻醉维持,对照组应用丙泊酚复合七氟醚麻醉维持。对比两组患儿手术、麻醉、拔管与苏醒的时间,不同麻醉时间点血流动力学指标,苏醒期躁动与麻醉相关不良反应发生率。结果研究组麻醉时间(60.6±3.0)min、拔管时间(7.0±0.5)min、苏醒时间(15.5±0.9)min与对照组(61.5±3.5)min、(7.2±0.6)min、(15.3±0.8)min对比,差异无统计学意义(t=1.069、1.403、0.910,P>0.05)。研究组T1时MAP(79.5±3.6)mmHg较对照组(87.6±5.6)mmHg更低,差异有统计学意义(t=6.664,P<0.01);T1时HR(97.6±2.5)次/min、T3时HR(98.6±2.8)次/min较对照组(106.5±3.0)次/min、(103.6±3.8)次/min更低,差异有统计学意义(t=12.483、5.802,P<0.01)。研究组苏醒期躁动的发生率为6.67%低于对照组的30.00%,差异有统计学意义(χ^(2)=5.455,P<0.05)。研究组麻醉相关不良反应发生率为10.00%与对照组3.33%对比,差异无统计学意义(χ^(2)=0.268,P>0.05)。结论右美托咪定可以缓解手术患儿麻醉时的血流动力学波动,预防苏醒期躁动。Objective To investigate the effect of dexmedetomidine on hemodynamic indexes and restlessness during awakening in children undergoing anesthesia during surgery.Methods 60 children with acute appendicitis treated in the hospital from January 2018 to June 2020 were randomly divided into control group and study group,with 30 cases in each group.Both groups underwent laparoscopic appendectomy under general anesthesia.The study group was maintained with dexmedetomidine combined with sevoflurane anesthesia,and the control group was maintained with propofol combined with sevoflurane anesthesia.The time of operation,anesthesia,extubation and recovery,hemodynamic indicators at different anesthesia time points,and the incidence of agitation and anesthesia-related adverse reactions were compared between the two groups of children.Results There was no significant difference in anesthesia time(60.6±3.0)min,extubation time(7.0±0.5)min,recovery time(15.5±0.9)min between the study group and the control group(61.5±3.5)min,(7.2±0.6)min,(15.3±0.8)min(t=1.069,1.403,0.910,P>0.05).The MAP(79.5±3.6)mmHg in the study group was lower than that in the control group(87.6±5.6)mmHg at T1,and the difference was statistically significant(t=6.664,P<0.01);the HR at T1(97.6±2.5)times/min and T3(98.6±2.8)times/min were lower than those in the control group(106.5±3.0)times/min and(103.6±3.8)times/min,the difference was statistically significant(t=12.483,5.802,P<0.01).The incidence of agitation in the study group was 6.67%lower than 30.00%in the control group,the difference was statistically significant(χ^(2)=5.455,P<0.05).The incidence of anesthesia related adverse reactions in the study group was 10.00%,compared with 3.33%in the control group,the difference was not statistically significant(χ^(2)=0.268,P>0.05).Conclusion Dexmedetomidine can alleviate hemodynamic fluctuations during anesthesia in children undergoing surgery and prevent restlessness during the recovery period.

关 键 词：右美托咪定 手术 患儿 麻醉 血流动力学 苏醒期躁动 

分 类 号：R726[医药卫生—儿科]