右美托咪啶与氯胺酮对非气管插管七氟醚全身麻醉患儿苏醒期躁动的预防效果比较被引量：12

导出

摘要目的比较右美托咪啶与氯胺酮对保留自主呼吸面罩紧闭吸入七氟醚全身麻醉患儿苏醒期躁动的预防效果及不良反应。方法择期行疝修补术或睾丸鞘膜翻转术患儿60例,随机分为P组、D组、K组,每组20例。3组均采用保留自主呼吸面罩紧闭吸入七氟醚全身麻醉,吸入麻醉诱导成功后,建立静脉通道,D组泵注右美托咪定0.3μg/kg,K组泵注氯胺酮0.5 mg/kg,P组泵注生理盐水10 ml,均在15 min内泵注完毕。记录患儿苏醒时间、离室时间、苏醒期躁动、FLACC疼痛评分及不良反应发生情况。结果 D组、K组苏醒期躁动评分及躁动发生率低于P组(P<0.05),且D组低于K组(P<0.05);K组患儿FLACC疼痛评分明显高于P组、D组(P<0.05);K组苏醒时间、离室时间均长于D组、P组(P<0.05),D组和P组之间无统计学差异(P>0.05);3组患儿均无呼吸抑制及恶心、呕吐等不良反应。结论右美托咪啶及小剂量氯胺酮均可降低小儿七氟醚全身麻醉后苏醒期躁动的发生,但右美托咪啶效果更佳。

作者徐辉吴毅郭明炎王丽漫李扬孙来保

机构地区中山大学附属孙逸仙纪念医院麻醉科中山大学附属第一医院麻醉科

出处《广西医学》 CAS 2014年第9期1292-1294,共3页 Guangxi Medical Journal

关键词全身麻醉右美托咪啶氯胺酮七氟醚小儿苏醒期躁动

分类号 R614.2 [医药卫生—麻醉学]

引文网络
相关文献

参考文献9

1徐坚,连庆泉,陈小玲,占恭豪,庄晓彪.七氟醚用于小儿非住院手术麻醉的可行性[J].中华麻醉学杂志,2000,20(4):248-249. 被引量：113
2Kuratani N, Oi Y. Greater incidence of emergence agitation in children after sevoflurane anesthesia as compared with halothane: a meta-maalysis of randomized controlled trials [ J ]. Anesthesiology,2008,109 (2) :225 - 232.
3Ibacache ME,Mufioz HR,Brandes V,et al. Single-dose dexme- detomidine reduces agitation after sevotlurance anesthesia in children[J]. Anesth Analg,2004,98(1) :60 -63.
4Dalens BJ ,Pinard AM, Ltourneau DR, et al. Prevention of e- mergence agitation after sevoflurane anesthesia for pediatric cerebral magnetic resonance imaging by small doses of ket- amine or nalbuphine administered just before discontinuing anesthesia [ J ]. Anesth Analg,2006,102 (4) : 1 056 - 1 061.
5Dahmani S, Stany I, Brasher C, et al. Pharmacological pre- vention of sevoflurane- and desflurane-related emergence ag- itation in children : a meta-analysis of published studies [ J ]. Br J Anaesth, 2010,104 (2) : 216 - 223.
6朴连玉,冯雅珍,李飞,冯艳华,麻海春.右美托咪啶及小剂量氯胺酮预防小儿全麻苏醒期躁动的对比观察[J].中国妇幼保健,2013,28(4):696-698. 被引量：20
7胡蓉,姜虹,朱也森.小儿七氟烷全身麻醉苏醒期烦躁的研究进展[J].上海交通大学学报（医学版）,2009,29(5):598-601. 被引量：22
8卢桠楠,许冬妮,周嘉嘉,纪风涛,曹铭辉.小儿全身麻醉苏醒期躁动的危险因素分析[J].中山大学学报（医学科学版）,2013,34(2):240-243. 被引量：97
9Fairbanks CA, Stone LS, Wilcox GL. Pharmacological pro- files of alpha 2 adrenergic receptor agonists identied using genetically altered mice and isobolographic analysis [ J ]. Pharmacol Ther,2009,123 (4) :224 - 238.

二级参考文献52

1蒋丽丹,张溪英.小儿腺样体扁桃体摘除术后麻醉恢复期的护理[J].护士进修杂志,2007,22(7):652-653. 被引量：18
2Shibata S,Shigeomi S,Sato W,et al.Nitrous oxide administration during washout of sevoflurane improves postanesthetic agitation in children[J].J Anesth,2005,19(2):160-163.
3Abu-Shahwan I,Chowdary K.Ketamine is effective in decreasing the incidence of emergence agitation in children undergoing dental repair under sevoflurane general anesthesia[J].Paediatr Anaesth,2007,17(9):846-850.
4Ko YP,Huang CJ,Hung YC,et al.Premedication with low-dose oral midazolam reduces the incidence and severity of emergence agitation in pediatric patients following sevoflurane anesthesia[J].Acta Anaesthesiol Sin,2001,39(4):169-177.
5Breschan C,Platzer M,Jost R,et al.Midazolam does not reduce emergence delirium after sevoflurane anesthesia in children[J].Paediatr Anaesth,2007,17(4):347-352.
6McGraw T,Kendrick A.Oral midazolam premedication and post-operative behaviour in children[J].Paediatr Anaesth,1998,8(2):117-121.
7Hung WT,Chen CC,Liou CM,et al.The effects of low-dose fentanyl on emergence agitation and quality of life in patients with moderate developmental disabilities[J].J Clin Anesth,2005,17(7):494-498.
8Demirbilek S,Togal T,Cicek M,et al.Effects of fentanyl on the incidence of emergence agitation in children receiving desflurane or sevoflurane anaesthesia[J].Eur J Anaesthesiol,2004,21(7):538-542.
9Tazeroualti N,De Groote F,De Hert S,et al.Oral clonidine vs midazolam in the prevention of sevoflurane-induced agitation in children.a prospective,randomized,controlled trial[J].Br J Anaesth,2007,98(5):667-671.
10Malviya S,Voepel-Lewis T,Ramamurthi RJ,et al.Clonidine for the prevention of emergence agitation in young children:efficacy and recovery profile[J].Paediatr Anaesth,2006,16(5):554-559.