摘要
目的观察右美托咪定用于小儿麻醉对血流动力学及苏醒期躁动和术后疼痛的影响。方法选择2016年3月~2017年3月武汉大学人民医院收治的接受扁桃体、腺样体择期切除术的患儿60例,随机分为右美托咪定组和对照组,每组各30例。右美托咪定组给予右美托咪复合七氟醚行麻醉维持,对照组仅给予七氟烷维持麻醉,比较两组患儿的手术时间、麻醉时间、拔管时间及苏醒时间;比较两组患儿麻醉前(T0)、气管插管时(T1)、手术开始即刻(T2)、手术结束即刻(T3)、心率(HR)、平均动脉压(MAP);比较两组患儿躁动量化评分(PAED)、躁动发生率及术后疼痛程度(FPS评分)。结果两组患儿一般情况及手术、麻醉、拔管及苏醒时间差异均无统计学意义(P>0.05);两组间T1、T2、T3时点HR、MAP值均高于T0,T0时点HR、MAP两组差异均无统计学意义(P>0.05);与对照组比较,右美托咪定组T1时点HR和MAP值,T3时点HR值均低于对照,差异有统计学意义(P<0.05);右美托咪定组患儿躁动发生率低于对照组,PAED评分和FPS疼痛评分均低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定用于小儿择期手术可发挥稳定血流动力学,降低躁动发生和减轻疼痛的作用,可增加麻醉的安全性与舒适性。
Objective To observe the effects of Dexmedetomidine on hemodynamics, emergence agitation and postoper- ative pain in children under anesthesia. Methods A total of 60 children with tonsillectomy and adenoideetomy in Ren- rain Hospital of Wuhan Universiy from March 2016 to March 2017 were selected and randomly divided into Dexmedetomidine group and control group, with 30 cases in each group. Children in the Dexmedetomidine group were given the Dexmedetomidine combined with Sevoflurane for maintenance of anesthesia, and children in the control group were given the Sevoflurane only for anesthesia maintenance. The operation time, anesthesia time, extubation time and recovery time, Heart rate （HR） and mean arterial pressure （MAP） were compared between the two groups in the times that before anesthesia （To）, tracheal intubation （TI）, beginning of surgery （T2）, end of surgery （T3）. The incidence of e- mergence agitation, the PAED score and FPS score were investigated in the two groups. Results There were no statisti- cally significant difference in operation time, anesthesia time, extubation time and recovery time between the two groups （P 〉 0.05）. HR and MAP were higher at the time Tl, T2 and T3 than those at To in both groups and there was no statisti- cally significant difference in HR and MAP at To between the two groups （P 〉 0.05）. Compared with the control group, HR and MAP at Tt and HR at T3 in the Dexmedetomidine group were lower than those in the control group, the differ- ences were statistically significant （P 〈 0.05）. The incidence of emergence agitation in the Dexmedetomidine group was lower than the control group, the PAED score and FPS score were lower in the Dexmedetomidine group than those in the control group, the differences were statistically significant （P 〈 0.05）. Conclusion Dexmedetomidine can improve the hemodynamies, reduce emergence agitation and relieve postoperative pain in children, which increases the safety and comfort of anesthesia.
作者
袁振武
杨昌明
王龙
YUAN Zhenwu;YANG Mingchang;WANG Long(Department of Anesthesiology, Renmin Hospital of Wuhan Universiy, Hubei Province, Wuhan 430060, China;De- partment of Anesthesiology, Jingmen No 1 People＇s Hospital, Hubei Province, Jingmen 448000, China)
出处
《中国医药导报》
CAS
2018年第7期94-97,106,共5页
China Medical Herald
基金
国家自然科学基金资助项目(81772044)
关键词
右美托咪定
麻醉
小儿
血流动力学
苏醒期躁动
术后疼痛
Dexmedetomidine
Anesthesia
Children
Hemodynamics
Emergence agitation
Postoperative pain
