右美托咪定复合阿芬太尼在小儿扁桃体及腺样体手术切除术的麻醉效果评价  

Evaluation of the Anesthetic Effect of Dexmedetomidine Combined with Alfentanil in Pediatric Tonsil and Adenoid Surgical Resection

作　　者：王萍 胡强 程乐 李云 章征兵[1] WANG Ping;HU Qiang;CHENG Le;LI Yun;ZHANG Zhengbing(Jiangxi Children's Hospital,Nanchang Jiangxi 330000,China.)

机构地区：[1]江西省儿童医院,江西南昌330000

出　　处：《药品评价》2024年第1期124-127,共4页Drug Evaluation

摘　　要：目的探究右美托咪定复合阿芬太尼在扁桃体及腺样体手术切除术的麻醉效果。方法选取2021年10月至2022年12月60例在江西省儿童医院行扁桃体及腺样体切除的患儿,以随机数字表法分成对照组与试验组,各30例。试验组给予右美托咪定滴鼻,后两组依次静脉注射戊乙奎醚,丙泊酚,苯磺顺阿曲库铵注射液,阿芬太尼,术中以阿芬太尼及丙泊酚静脉泵入维持麻醉,根据术中心率(HR)、平均动脉压(MAP)和脑电双频谱指数(BIS)值变化调整丙泊酚用量。观察两组手术时间。对比两组手术开始时,手术开始后10 min、20 min患儿的HR、MAP和BIS值变化,比较两组术中丙泊酚用量。记录患儿恶心、呕吐、苏醒期躁动、术后出血、呼吸抑制不良反应发生率。结果手术开始后10 min、20 min对照组HR、MAP、BIS值及丙泊酚用量、苏醒期躁动发生率均高于试验组,差异有统计学意义(P<0.05)。结论右美托咪定复合阿芬太尼用于小儿扁桃体及腺样体切除术,可提供良好的麻醉效果。Objective To evaluate the anesthetic effect of dexmedetomidine combined with alfentanil in surgical resection of tonsils and adenoids.Methods Sixty cases of children with tonsil and adenoid resection in Jiangxi Children's Hospital,from November 2021 to February 2023 were selected and divided into the control group and the experimental group,each with 30 cases,by random number table method.The experimental group was given dexmedetomidine nasal drops,and the two groups were sequentially intravenous injected with penehyclidine,propofol,benzenesulfonate cisatracurium injection,and fentanyl.During the operation,fentanyl and propofol were pumped intravenously to maintain anesthesia,the dosage of propofol was adjusted according to changes in operating heart rate(HR),mean arterial pressure(MAP),and bispectral index(BIS)values.Compare the changes of HR,MAP and BIS at the beginning of surgery,10 min and 20 min after the beginning of surgery,and compare the intraoperative alfentanil dosage between the two groups.The incidence of adverse reactions such as skin itching,nausea,vomiting and respiratory depression were recorded.Results The HR,MAP,BIS values and propofol dosage and the incidence of agitation during awakening were higher in the control group than in the experimental group at 10 min and 20 min after the start of surgery,and the difference were statistically significant(P<0.05).Conclusion Dexmedetomidine combined with alfentanil for pediatric tonsil and adenoidectomy can provide good anesthesia.

关 键 词：右美托咪定 阿芬太尼 小儿 扁桃体及腺样体切除术 

分 类 号：R726.1[医药卫生—儿科]