右美托咪定联合依托咪酯用于小儿先天性心脏病介入手术的麻醉效果及对患儿苏醒质量的影响  

Anesthetic effect of dexmedetomidine combined with etomidate in cardiac interventional surgery for congenital heart disease in children and its impact on recovery quality

作　　者：魏巍[1] 陈三冬 王帅[1] 魏峥 贾英萍 Wei Wei;Chen Sandong;Wang Shuai;Wei Zheng;Jia Yingping(Department of Anesthesia,Children’s Hospital Affiliated to Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院麻醉科,郑州450000

出　　处：《中国实用医刊》2023年第10期43-46,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨右美托咪定联合依托咪酯用于小儿先天性心脏病介入手术的麻醉效果及对患儿苏醒质量的影响。方法本研究为前瞻性随机对照试验。抽取2020年6月至2022年6月郑州大学附属儿童医院先天性心脏病患儿84例,按照随机数字表法分为对照组和研究组,每组42例。两组患儿均接受心脏介入手术治疗,对照组采用依托咪酯进行麻醉,研究组采用依托咪酯联合右美托咪定进行麻醉。比较两组患儿入室时(T1)、麻醉诱导即刻(T2)、气管插管后(T3)、手术结束时(T4)的血流动力学指标,比较两组患儿的苏醒时间、苏醒期躁动评分。结果T1时两组患儿的心率和平均动脉压比较,差异未见统计学意义(P>0.05);T2~T4时两组患儿的心率和平均动脉压呈逐渐下降趋势,且研究组下降幅度小于对照组(P<0.05);两组患儿的心率和平均动脉压组间、时点、组间·时点比较,差异均有统计学意义(P均<0.05)。研究组患儿的苏醒时间[(12.12±1.56)min]短于对照组[(14.24±2.05)min],苏醒期躁动量表评分[1.00(0.00,1.00)分]低于对照组[1.50(1.00,2.00)分],差异有统计学意义(P<0.05)。结论右美托咪定联合依托咪酯用于小儿先天性心脏病介入手术的麻醉效果较好,能维持患儿的血流动力学稳定,缩短患儿苏醒时间,减少其苏醒期躁动。Objective To investigate the anesthetic effect of dexmedetomidine combined with etomidate in cardiac interventional surgery for congenital heart disease in children and its impact on the quality of recovery in children.Methods This study was a prospective randomized controlled trial.A total of 84 children with congenital heart disease admitted to Children’s Hospital Affiliated to Zhengzhou University from June 2020 to June 2022 were selected,and they were divided into control group and study group according to the random number table method,with 42 cases in each group.Both groups received cardiac interventional surgery.The control group was anesthetized with etomidate,while the study group was anesthetized with etomidate combined with dexmedetomidine.The hemodynamic indicators at entry(T1),immediately after anesthesia induction(T2),after tracheal intubation(T3),and at the end of surgery(T4)were compared between the two groups.The awakening time and pediatric anesthesia emergence delirium scale score were compared between the two groups.Results There was no statistical significant difference in heart rate and mean arterial pressure between the two groups at T1(P>0.05).The heart rate and mean arterial pressure of the two groups at T2-T4 showed a gradual downward trend,and the decline in the study group was smaller than that in the control group(P<0.05).There were statistically significant differences in inter-group comparison,intra-group comparison and inter-group different-time comparison of heart rate and mean arterial pressure(all P<0.05).The recovery time in the study group was(12.12±1.56)min,shorter than the(14.24±2.05)min in the control group,while the pediatric anesthesia emergence delirium scale score in the study group was 1.00(0.00,1.00),which was lower than the 1.50(1.00,2.00)in the control group(P<0.05).Conclusions The anesthetic effect of dexmetomidine combined with etomidate in the operation of congenital heart disease is good,which can maintain the hemodynamic stability,shorten the recovery time,

关 键 词：依托咪酯 先天性心脏病 右美托咪定 麻醉 血流动力学 

分 类 号：R726.1[医药卫生—儿科]