右美托咪定辅助静吸麻醉在小儿上消化道特殊异物取出术中的应用及对苏醒期躁动的影响  

Application of Dexmedetomidine Supplemented with Intravenous Inhalation Anesthesia during Upper Gastrointestinal Tract Special Foreign Body Removal in Children and its Influence on Restlessness during Recovery

作　　者：张爽 孟凡涛 ZHANG Shuang;MENG Fan-tao(Endoscopy Room,Qinhuangdao Haigang Hospital,Qinhuangdao 066000,China;Endoscopy Room,Qin-huangdao Jungong Hospital,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市海港医院内窥镜室,河北秦皇岛066000 [2]河北省秦皇岛市军工医院内窥镜室,河北秦皇岛066000

出　　处：《药物生物技术》2023年第6期618-622,共5页Pharmaceutical Biotechnology

基　　金：秦皇岛市重点研发计划科技支撑项目(No.202101A034)。

摘　　要：探究右美托咪定辅助静吸麻醉在小儿上消化道特殊异物取出术中的应用及对苏醒期躁动的影响。选取本院2021年10月至2022年10月收治的150例上消化道磁性异物患者,按照随机数字表法分为对照组(n=75,常规静吸麻醉)和观察组(n=75,右美托咪定辅助静吸麻醉)。比较两组血流动力学指标、手术相关指标、苏醒期躁动程度、炎症及不良反应发生情况。两组进镜1 min、进镜5 min的平均动脉压(MAP)、心率(HR)均较进镜前升高,血氧饱和度(SpO_(2))较进镜前降低(P<0.05);观察组进镜1 min、进镜5 min的MAP、HR水平均低于对照组,SpO_(2)高于对照组(P<0.05);观察组丙泊酚及瑞芬太尼用量少于对照组,手术时间短于对照组(P<0.05);观察组苏醒期躁动评分(RS)低于对照组,Ramsay镇静评分(RSS)高于对照组(P<0.05);两组手术结束后的血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均较术前升高,观察组术后CRP、TNF-α及IL-6水平低于对照组(P<0.05);观察组不良反应总发生率低于对照组(P<0.05)。在小儿上消化道特殊异物取出术中应用右美托咪定辅助静吸麻醉,可维持患儿血流动力学稳定,减少丙泊酚及瑞芬太尼用量,预防苏醒期躁动,减轻炎症反应,降低麻醉不良反应发生率,是较为安全的复合麻醉方式。The aim of this study was to explore the application of dexmedetomidine supplemented with intravenous inhalation anesthesia during upper gastrointestinal tract special foreign body removal in children and its influence on restlessness during recovery.150 patients with upper gastrointestinal tract magnetic foreign bodies admitted to the hospital from October 2021 to October 2022 were selected and divided into control group(n=75,conventional intravenous inhalation anesthesia)and observation group(n=75,dexmedetomidine supplemented with intravenous inhalation anesthesia)according to the random number table method.Hemodynamic indicators,surgical-related indicators,restlessness degree during recovery,inflammation and occurrence of adverse reactions were compared between the two groups.The mean arterial pressure(MAP)and heart rate(HR)in the two groups after 1 min and 5 min of insertion were increased compared with those before insertion while the blood oxygen saturation(SpO_(2))was decreased compared with that before insertion(P<0.05).MAP and HR in observation group after 1 min and 5 min of insertion were lower than those in control group while SpO_(2) was higher than that in control group(P<0.05).The dosages of propofol and remifentanil in observation group were less than those in control group,and the surgical time was shorter than that in control group(P<0.05).The restlessness score(RS)during recovery in observation group was lower than that in control group while the ramsay sedation score(RSS)was higher than that in control group(P<0.05).The levels of serum C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in both groups were increased after the end of surgery compared with those before surgery,and the levels of CRP,TNF-α and IL-6 were lower in observation group compared with those in control group after surgery(P<0.05).The total incidence rate of adverse reactions in observation group was lower than that in control group(P<0.05).The application of dexmedetomidine supplemented with intr

关 键 词：右美托咪定 静吸麻醉 小儿 上消化道特殊异物取出术 血流动力学 苏醒期躁动 炎症反应 

分 类 号：R614[医药卫生—麻醉学]