不同右美托咪定给药时机在全麻儿童龋齿治疗中的效果比较  

Effect of different timing of dexmedetomidine administration in children’s dental caries treatment under general anesthesia

作　　者：蒋超[1] 仇琳[1] 林宇[1] JIANG Chao;QIU Lin;LIN Yu(Department of Anesthesiology,Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院麻醉科,上海200011

出　　处：《中国口腔颌面外科杂志》2021年第6期546-548,共3页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨不同右美托咪定给药时机在全麻儿童龋齿治疗中的效果。方法:将120例择期行全麻龋齿治疗的患儿随机分为D1组、D2组、D3组,每组40例。所有患儿术中均使用七氟烷1.5 MAC维持麻醉,D1组术中不给予右美托咪定;D2组于麻醉诱导插管后给予0.5μg/(kg·h)右美托咪定,持续泵注10 min;D3组于手术结束前泵注0.5μg/(kg·h)右美托咪定10 min。记录3组患儿入室时(T0)、手术开始时(T1)、手术1 h时(T2)、术毕时(T3)的心率及平均动脉压;从七氟烷关闭至拔管时间及苏醒时间;入麻醉后监测治疗室(PACU)的麻醉苏醒躁动评分(PAED)和疼痛评分(FLACC)。采用SPSS 21.0软件包对数据进行统计学分析。结果:与同组T0时相比,3组T1、T2和T3时心率、平均动脉压显著降低(P<0.05);与D1组相比,D2组T1、T2和T3时心率和平均动脉压显著降低(P<0.05),D3组T3时心率和平均动脉压显著降低(P<0.05)。与D1组相比,D2组D3组PAED和FLACC评分显著低于D1组(P<0.05)。结论:麻醉诱导插管后泵入0.5μg/(kg·h)右美托咪定10 min,可使术中血流动力学稳定,减少麻醉苏醒躁动,同时不会影响麻醉苏醒及拔管时间,是较为合理的临床用药时机。PURPOSE:To investigate the effect of different timing of dexmedetomidine administration in children’s dental caries treatment under general anesthesia.METHODS:One hundred and twenty children scheduled for caries treatment were randomly divided into group D1,group D2 and group D3 with 40 cases in each group.Sevoflurane 1.5 Mac was used to maintain anesthesia in all children.Group D1 was not given dexmedetomidine.Group D2 was given 0.5μg/(kg·h)dexmedetomidine for 10 min after intubation.Group D3 was given 0.5μg/(kg·h)dexmedetomidine for 10 min before the end of operation.HR and MAP at the time of entering the operation room(T0),beginning of operation(T1),HR and MAP 1 hour after beginning of operation(T2)and ending of operation(T3)were measured;extubation time and recovery time were recorded;the anesthesia recovery agitation score(PAED)and pain score(FLACC)were calculated after entering the anes-thesia treatment unit(PACU).SPSS 21.0 software package was used to analyze the data.RESULTS:HR and MAP at T1,T2 and T3 were significantly lower than those at T0(P<0.05).Compared with group D1,HR and MAP at T1,T2 and T3 were significantly decreased in group D2(P<0.05).Compared with group D1,HR and MAP at T3 in group D3 decreased significantly(P<0.05).The extubation time and recovery time of group D1 and D2 were significantly shorter than those of group D3(P<0.05).Compared with group D1,PAED and FLACC in group D2 and D3 were significantly lower than those in group D1(P<0.05).CONCLUSIONS:Dexmedetomidine 0.5μg/(kg·h)pumped for 10 min after anesthesia induction intubation can stabilize the hemodynamics during operation,reduce agitation of anesthesia recovery,and do not affect the time of anesthesia recovery and extubation,which is a more reasonable time for clinical medication.

关 键 词：右美托咪定 龋齿 儿童 

分 类 号：R614.2[医药卫生—麻醉学]