本文選題：右美托咪啶 + 兒童　； 參考：《中國臨床藥理學雜志》2015年05期

【摘要】：目的觀察右美托咪啶對小兒心導管術麻醉維持和蘇醒質(zhì)量的影響。方法將擇期進行心導管術的1~11歲兒童隨機分為右美托咪啶復合七氟烷組(DS組)41例和七氟烷組(S組)43例。所有患兒均于入室后,靜脈注射氯胺酮1 mg·kg-1。DS組靜脈泵持續(xù)10 min輸入復合量的右美托咪啶1μg·kg-1,術中再予維持量2μg·kg-1·h-1,S組用0.9%氯化鈉代替。2組術中用腦電雙頻譜指數(shù)(BIS)監(jiān)測麻醉深度,通過調(diào)節(jié)七氟烷吸入濃度使BIS值維持在55~65之間。記錄2組患兒入室時(T0)、喉罩置入即刻(T1)、喉罩置入后20 min(T2)、喉罩拔除即刻(T3)各時點的心率、平均動脈壓、呼吸頻率、BIS值、呼氣末二氧化碳分壓及呼氣末七氟烷濃度,記錄手術時間、蘇醒時間、術后鎮(zhèn)靜藥使用情況及呼吸抑制、惡心、嘔吐等不良反應的發(fā)生。結(jié)果 T1~T3各時點的DS組心率明顯低于S組(P0.01)。T2、T3時點,DS組呼氣末七氟烷濃度明顯低于S組(P0.01)。DS組術后蘇醒時間明顯長于S組(P0.01)。初醒時點,DS組鎮(zhèn)靜躁動評分明顯低于S組(P0.01)。術后,DS組躁動需加鎮(zhèn)靜藥例數(shù)(12例)明顯少于S組(37例),2組比較差異有統(tǒng)計學意義(P0.01)。結(jié)論右美托咪啶能優(yōu)化小兒心導管術的麻醉維持和蘇醒質(zhì)量。
[Abstract]:Objective to observe the effect of dexmetidine on maintenance and recovery of anesthesia in pediatric cardiac catheterization. Methods the 11 year old children who underwent cardiac catheterization were randomly divided into desmetomidine combined sevoflurane group (n = 41) and sevoflurane group (n = 41) and sevoflurane group (n = 43). All the children were injected intravenously with ketamine 1 mg kg-1.DS for 10 min with dexmetidine 1 渭 g kg-1. the intraoperative maintenance 2 渭 g kg-1 h-1s group was given 0.9% sodium chloride instead of 0.9% sodium chloride to monitor the anesthetic depth during the operation of group 2. 2 (bispectral index of EEG) was used to monitor the anesthetic depth. By adjusting sevoflurane inhalation concentrations, BIS levels remain between 55 and 65. The heart rate, mean arterial pressure, respiratory frequency and BIS, end-expiratory partial pressure of CO _ 2 and concentration of end-expiratory sevoflurane were recorded at 20 min after laryngeal mask implantation and 20 min after laryngeal mask implantation, and the mean arterial pressure, BIS value, end-expiratory partial pressure and end-expiratory sevoflurane concentration were recorded. Recovery time, postoperative sedative use and respiratory inhibition, nausea, vomiting and other adverse reactions. Results the heart rate of DS group at each time point of T1~T3 was significantly lower than that of S group (P 0.01). T2 + T 3 was significantly lower than that of group S (P 0.01). The recovery time of group DS was significantly longer than that of group S (P 0.01). The sedative restlessness score of DS group was significantly lower than that of S group (P 0.01). There were 12 cases of restlessness and sedation needed in DS group after operation, which were significantly less than those in group S (37 cases) and the difference was statistically significant (P 0.01). Conclusion dexmetidine can optimize the anesthesia maintenance and recovery quality of pediatric cardiac catheterization.
【作者單位】： 溫州醫(yī)科大學附屬第二醫(yī)院麻醉科;溫州醫(yī)科大學附屬第二醫(yī)院小兒心內(nèi)科;
【基金】：浙江省自然基金資助項目(Y2110380) 溫州市科技局項目(Y20130130)
【分類號】：R726.1

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