摘要
目的研究右美托咪定在小儿腔镜手术中的麻醉效果及对应激影响。方法以2016年1月-2017年12月80例腹腔镜阑尾切除术患儿随机分为干预组和常规组,各40例。常规组咪达唑仑、瑞芬太尼、丙泊酚、七氟烷复合麻醉,干预组右美托咪定、瑞芬太尼、丙泊酚、七氟烷复合麻醉。记录呼吸恢复及苏醒时间,泵注药物前一刻(T1)、诱导前一刻(T2)、插管即刻(T3)、气腹建立完成时(T4)、拔管即刻(T5)心率、平均血压和血氧饱和度;检测各时间点血清肾上腺素、皮质醇浓度。结果干预组T2-T5心率、平均血压均显著低于常规组,P<0.05;干预组T1皮质醇及肾上腺素浓度与常规组比较无统计学意义,P>0.05,其余时间点均低于常规组,P<0.05,组内比较T2较T1明显降低,差异有统计学意义,P>0.05;干预组呼吸恢复时间、拔管时间均显著短于干预组,烦躁或哭闹及喉痉挛发生率显著低于常规组,P<0.05。结论右美托咪定在小儿腹腔镜阑尾切除术中可增加麻醉效果,尤其是可以减少围术期诱导插管和拔管时的应激反应,血流动力学更稳定,减少不良反应发生等。
Objective:To study the effect of dexmedetomidine on anesthesia and stress in pediatric endoscopic surgery.Methods From January 2016 to December 2017,80 children with laparoscopic appendectomy were randomly divided into the intervention group and the routine group,with 40 cases each.Routine group midazolam,remifentanil,propofol,sevoflurane combined anesthesia,intervention group,intervention group dexmedetomidine,remifentanil,propofol,sevoflurane combined anesthesia.Respiratory recovery and wake time were recorded,and the time before induction(T2),intubation(T3),pneumogastrostomy(T4),extubation(T5)heart rate,mean blood pressure and oxygen saturation were recorded at the moment before drug infusion(T1).Serum adrenaline and cortisol concentrations were measured at each time point.Results:T2-T5 heart rate and mean blood pressure in the intervention group were significantly lower than those in the conventional group,P<0.05.T1 cortisol and adrenalin concentration in the intervention group were not statistically significant compared with the conventional group,P>0.05,and the remaining time points were all lower than the conventional group,P<0.05.T2 was significantly reduced compared with T1 in the treatment group,and the difference was statistically significant,P>0.05.The respiratory recovery time and extubation time of the intervention group were significantly shorter than that of the intervention group,and the incidence of irritability or crying and laryngeal spasm was significantly lower than that of the conventional group,P<0.05.Conclusion dexmedetomidine can increase the anesthetic effect in laparoscopic appendectomy in children,especially can reduce the stress response during perioperative induction of intubation and extubation,hemodynamics is more stable,and reduce the occurrence of adverse reactions.
作者
李茂军
未彬秀
邓秋霞
朱晓东
LI Mao-jun;WEI Bin-xiu;Deng Qiu-xia;Zhu Xiao-dong(Department of anesthesiology Linshui Peoples,Hospital,Guangan 638500,Sichuan,China)
出处
《结直肠肛门外科》
2018年第A02期84-85,共2页
Journal of Colorectal & Anal Surgery
关键词
右美托咪定
七氟烷
腹腔镜
阑尾
皮质醇
肾上腺素
Dexmetomidine
sevoflurane
Laparoscope
The appendix.Cortisol
Adrenaline
