右美托咪定对七氟醚麻醉扁桃体切除术患儿苏醒期躁动的影响  

Effect of dexmedetomidine on restlessness in children with sevoflurane anesthesia after tonsillectomy

作　　者：司兴艳[1] 马风秀 Si Xingyan;Ma Fengxiu(Department of Anesthesiology,Binzhou Central Hospital,Binzhou,Shandong,251700,China)

机构地区：[1]滨州市中心医院,山东滨州251700

出　　处：《中国医学文摘（耳鼻咽喉科学）》2023年第4期93-95,共3页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的 讨论右美托咪定对七氟醚麻醉扁桃体切除术患儿苏醒期躁动的影响。方法 入选44例扁桃体切除术患儿主要于2021年2月-2022年3月接受病情诊疗,将其随机分为对照组22例与研究组22例。对照组采取七氟醚全身麻醉,研究组在对照组基础上以右美托咪定进行预处理及麻醉维持。观察指标:平均动脉压及心率不同时点监测情况;麻醉相关时间指标;苏醒期呛咳评分、躁动评分及疼痛评分。结果 两组进入手术室时的平均动脉压及心率指标无统计学意义(P>0.05);研究组气管插管后、手术开始时、扁桃体切除时、拔管后平均动脉压及心率更为平稳,明显优于对照组,存在统计学意义(P<0.05)。研究组麻醉时间、自主呼吸恢复时间、气管插管拔除时间及睁眼时间虽然稍长于对照组,但是对比无统计学意义(P>0.05)。研究组苏醒期呛咳评分、躁动评分及疼痛评分指标均明显低于对照组,存在统计学意义(P<0.05)。结论 对七氟醚麻醉扁桃体切除术患儿采取右美托咪定进行预处理及麻醉维持,不仅可起到平稳血压及心率的效果,且可减轻苏醒期呛咳反应、躁动反应及疼痛反应,同时不会对术后苏醒造成严重影响。Objective To investigate the effect of dexmedetomidine on agitation in children with sevoflurane anesthesia after tonsillectomy.Methods A total of 44 children with tonsillectomy received diagnosis and treatment from February 2021 to March 2022,and were randomly divided into control group(n=22)and study group(n=22).The control group received sevoflurane combined with fentanyl for general anesthesia,while the study group received dexmedetomidine for pretreatment and anesthesia maintenance on the basis of the control group.Observation indicators:average arterial pressure and heart rate monitoring at different time points;Time index related to anesthesia;Cough score,agitation score and pain score during resuscitation.Results There was no statistical significance in the mean arterial pressure and heart rate indexes of the two groups when entering the operating room(P>0.05).The average arterial pressure and heart rate in the study group were more stable after endotracheal intubation,at the beginning of surgery,tonsillectomy and extubation,which were significantly better than those in the control group,with statistical significance(P<0.05).The anesthesia time,spontaneous breathing recovery time,tracheal intubation extraction time and eye-opening time of the study group were slightly longer than those of the control group,but there was no statistical significance(P>0.05).The cough score,agitation score and pain score in the study group were significantly lower than those in the control group,with statistical significance(P<0.05).Conclusion Pretreatment and maintenance of dexmedetomidine for sevoflurane anesthesia tonsillectomy in children can not only stabilize blood pressure and heart rate,but also reduce the cough response,agitation and pain response in the wake up stage,and have a serious impact on postoperative wake up.

关 键 词：扁桃体切除术 右美托咪定 七氟醚 麻醉 

分 类 号：R61[医药卫生—外科学]