右美托咪定对儿童患者丙泊酚麻醉诱导诱发体动反应的抑制作用研究  

Study of the preventive effects of dexmedetomidine pretreatment on propofol-induced involuntary body movements in children

作　　者：刘英[1] 杨亚男 冯安琪 刘静[2] 李思远 王娟平[1] 薛荣亮 LIU Ying;YANG Yanan;FENG Anqi;LIU Jing;LI Siyuan;WANG Juanping;XUE Rong liang(Department of Anesthesiology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,Shaanxi Province,China;Outpatient Department,the Second Affiliated Hospital of Xi'an Medical University,Xi'an 710038,Shaanxi Province,China;Anesthesia and Comfort Medical Center,Xi'an International Medical Center Hospital,Xi'an 710100,Shaanxi Province,China)

机构地区：[1]西安交通大学第二附属医院麻醉科,陕西西安710004 [2]西安医学院第二附属医院门诊部,陕西西安710038 [3]西安国际医学中心医院麻醉与舒适化医疗中心,陕西西安710100

出　　处：《世界临床药物》2023年第7期725-729,共5页World Clinical Drug

基　　金：西安国际医学中心医院新技术项目(20211205)。

摘　　要：目的研究右美托咪定静脉预处理对丙泊酚麻醉诱导引起患儿不自主体动反应的有效性和安全性。方法全麻下行择期手术的3~9岁患儿60例,采用随机数字表法分为右美托咪定组和丙泊酚组,每组30例。右美托咪定组在麻醉诱导前以4μg/kg·h的速度持续泵注5 min右美托咪定,丙泊酚组以相同速度泵注等量生理盐水;两组患儿随后静脉注射丙泊酚、舒芬太尼及顺势阿曲库铵常规麻醉诱导。比较两组患儿麻醉诱导期不自主体动反应发生率及苏醒期情况。结果右美托咪定组患儿麻醉诱导期间总体动反应发生率以及中、重度体动反应发生率明显低于丙泊酚组(P<0.05)。两组患儿拔管时间、麻醉恢复室停留时间、麻醉恢复期不良反应发生率、镇静躁动及疼痛程度评分比较均无统计学差异(P>0.05)。结论右美托咪定预处理可安全有效地降低麻醉诱导期间由丙泊酚引起的患儿不自主体动反应发生率。Objective To investigate the efficacy and safety of intravenous dexmedetomidine pretreatment in children with involuntary body reaction induced by propofol anesthesia.Methods Sixty children aged 3~9 years old undergoing elective surgery under general anesthesia were randomly divided into dexmedetomidine group and propofol group,with 30 cases in each group.Dexmedetomidine group was continuously injected with dexmedetomidine at the rate of 4μg/kg·h for 5 min before anesthesia induction,and propofol group was injected with the same amount of normal saline at the same rate.The children in both groups were then given intravenous propofol,sufentanil and homeopathic atracurium for routine anesthesia induction.The incidence of involuntary body movement during anesthesia induction and recovery period were compared between the two groups.Results Compared with the propofol group,the dexmedetomidine group had significantly lower incidence rate of overall involuntary body movement and moderate and severe body reaction during anesthesia induction(P<0.05).There were no significant differences in extubation time,duration of stay in anesthesia recovery room,incidence of adverse reactions during anesthesia recovery,sedation,agitation and pain degree between the two groups(P>0.05).Conclusion Dexmedetomidine pretreatment can safely and effectively reduce the incidence of involuntary body reaction induced by propofol during anesthesia induction.

关 键 词：右美托咪定 儿童 丙泊酚 不自主运动 有效性 安全性 

分 类 号：R614.2[医药卫生—麻醉学]