本文選題：右美托咪定 + 兒童��； 參考：《廣東醫(yī)學(xué)》2017年11期

【摘要】：目的探討右美托咪定預(yù)防兒童全麻蘇醒期躁動和譫妄的安全有效劑量。方法選取擇期行全麻下腹腔鏡下疝囊高位結(jié)扎術(shù)的患兒120例,隨機分為4組,A、B、C組患兒分別經(jīng)靜脈恒速(60 m L/h)泵注0.25、0.5和1μg/kg右美托咪定,D組(對照組)以相同的速度泵入生理鹽水。對比4組患兒的5點評分量表評分和蘇醒期譫妄(ED)和躁動(EA)發(fā)生率。比較4組患兒的兒童和嬰兒術(shù)后疼痛評分(CHIPPS評分),記錄七氟烷的用量及手術(shù)時間(TO),停止麻醉藥物至拔喉罩時間(TM)、自主睜眼時間(TE),記錄患兒在麻醉后監(jiān)護室停留的時間(TP)。結(jié)果 4組患兒TO比較差異無統(tǒng)計學(xué)意義(P0.05),其中B、C組TM顯著高于A、D組(P0.05),C組顯著高于B組(P0.05);其中A、B、D三組的TE和TP比較差異無統(tǒng)計學(xué)意義(P0.05),C組TE顯著高于A、B、D三組(P0.05);而C組TP顯著高于A、D組(P0.05),而B、C兩組的TP比較差異無統(tǒng)計學(xué)意義(P0.05);A、B、C三組的5點評分量表評分、EA和ED發(fā)生率均顯著低于D組(P0.05),3項指標(biāo)中B、C組均顯著低于A組(P0.05),B、C組之間差異無統(tǒng)計學(xué)意義(P0.05);A、B、C三組的CHIPPS評分和七氟烷的用量均顯著低于D組(P0.05),而B、C組顯著低于A組(P0.05),B、C組之間差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論兒童全麻中使用右美托咪定0.5μg/kg的劑量可安全有效地預(yù)防患兒手術(shù)后蘇醒期躁動和譫妄,能減少術(shù)中七氟烷用量及減輕術(shù)后疼痛。
[Abstract]:Objective to investigate the safe and effective dose of dexmetomidine in preventing restlessness and delirium during general anesthesia in children.Methods one hundred and twenty children undergoing laparoscopic high ligation of hernia sac under general anesthesia were randomly divided into 4 groups: group A (n = 4) were injected intravenously with constant velocity of 60 mL / h and group D (n = 1 渭 g/kg) were pumped into normal saline at the same speed.The five-point rating scale (5-score) and the incidence of delirium (EDV) and restlessness (EAA) in the recovery period were compared among the 4 groups.The postoperative pain scores of children and infants in the four groups were compared, the dosage of sevoflurane and the time of operation were recorded, the time of stopping anaesthesia to larynx mask and the time of spontaneous eye opening were recorded, and the time of staying in the intensive care unit after anesthesia was recorded.Results there was no significant difference in to between the four groups, among which TM in group B was significantly higher than that in group B (P 0.05), and the te and TP in group A were significantly higher than that in group B (P 0.05). There was no significant difference in te and TP between group C and group C (P 0.05), but that in group C was significantly higher than that in group ABD (P 0.05), while in group B (P 0.05), there was no significant difference between group A (P 0.05) and group C (P 0.05), and there was no significant difference between group B (P 0.05) and group C (P 0.05).TP in group C was significantly higher than that in group A (P 0.05), but there was no significant difference in TP between the two groups. The scores of EA and Ed in group C were significantly lower than those in group D (P 0.05) and the incidence of Ed in group B was significantly lower than that in group A (P 0.05) and the incidence of Ed in group C was significantly lower than that in group A (P 0.05) and the incidence of Ed in group C was significantly lower than that in group A (P 0.05) and the incidence of Ed in group C was significantly lower than that in group A (P 0.05).The CHIPPS score and sevoflurane dosage of P0.05An BHG C group were significantly lower than that of D group (P 0.05), while the BHG C group was significantly lower than that of A group (P 0.05) BHG group. There was no significant difference (P 0.05) between group A and group B (P < 0.05), but there was no significant difference between group A (P 0.05) and group A (P 0.05).Conclusion the dose of dexmetomidine 0.5 渭 g/kg in children with general anesthesia can prevent restlessness and delirium during postoperative recovery, reduce the dosage of sevoflurane during operation and relieve postoperative pain.
【作者單位】： 佛山市婦幼保健院麻醉科;佛山市婦幼保健院新生兒科;
【分類號】：R726.1

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