發(fā)布時(shí)間：2018-06-20 10:59

  本文選題：右美托咪定 + 小兒　； 參考：《河北醫(yī)藥》2016年23期

【摘要】：目的研究右美托咪定(dexmedetomidine,DEX)對(duì)小兒扁桃體腺樣體切除術(shù)全身麻醉蘇醒質(zhì)量的影響。方法選擇小兒行扁桃體腺樣體切除手術(shù)患者90例,隨機(jī)分為3組,每組30例。右美托咪定1組(D1組)于手術(shù)結(jié)束前30 min靜脈注射右美托咪定0.5μg/kg;右美托咪定2組(D2組)于手術(shù)結(jié)束前30 min靜脈注射右美托咪定1μg/kg;對(duì)照組(C組)靜脈注射等容量0.9%氯化鈉溶液。采用靜脈快速誘導(dǎo)全身麻醉,術(shù)中以七氟醚復(fù)合瑞芬太尼維持麻醉。記錄用藥前T0,手術(shù)結(jié)束時(shí)T1,拔出氣管導(dǎo)管即刻T2,拔管后5 min T3平均動(dòng)脈壓(MAP)值和心率(HR),并觀察記錄蘇醒期不良反應(yīng)(喉痙攣、惡心嘔吐、躁動(dòng)、蘇醒延遲等)的發(fā)生情況。結(jié)果 3組患兒一般情況比較(年齡、體重)差異均無統(tǒng)計(jì)學(xué)意義(P0.05);3組患兒手術(shù)時(shí)間、拔管時(shí)間差異無統(tǒng)計(jì)學(xué)意義(P0.05),D2組蘇醒時(shí)間比C組和D1組明顯延長(zhǎng)(P0.05);在T1、T2、T3時(shí)間點(diǎn),D1及D2組MAP和HR值均比C組降低(P0.05);D1及D2組喉痙攣、惡心嘔吐、躁動(dòng)的發(fā)生率比C組明顯降低(P0.05);D2組術(shù)后蘇醒延遲發(fā)生率比C組和D1組明顯增高(P0.05)。結(jié)論手術(shù)結(jié)束前30 min靜脈注射0.5μg/kg的右美托咪定可安全有效的應(yīng)用于小兒扁桃體腺樣體切除術(shù),使血流動(dòng)力學(xué)更加穩(wěn)定,降低不良反應(yīng)的發(fā)生率,提高蘇醒質(zhì)量。
[Abstract]:Objective to study the effect of dexmemedetomine Dex (DEX) on the recovery quality of general anesthesia after tonsillectomy in children. Methods 90 children with tonsillectomy were randomly divided into 3 groups, 30 cases in each group. Dexmetomidine group 1 (group D 1): dexmetomidine 0.5 渭 g / kg intravenously 30 min before operation; dexmetomidine group 2 (group D 2) intravenous injection of dexmetomidine 1 渭 g / kg 30 min before operation; control group C) 0.9% sodium chloride solution intravenously. General anesthesia was induced by intravenous fast induction, and sevoflurane combined with remifentanil was used to maintain anesthesia. The values of T _ 0, T _ 1 at the end of operation, T _ 2 immediately after tracheal catheter extraction, mean arterial pressure at 5 min after extubation and heart rate were recorded, and the occurrence of adverse reactions (laryngeal spasm, nausea and vomiting, restlessness, delayed recovery, etc.) was observed. Results there was no significant difference in general conditions (age, body weight) among the three groups. There was no significant difference in extubation time between group D 2 and group C and group D1, map and HR values in group D 1 and group D 2 were significantly lower than those in group C and group D 2. The incidence of restlessness in group D 2 was significantly lower than that in group C (P 0.05) and the incidence of delayed postoperative recovery in group D 2 was significantly higher than that in group C and group D1. Conclusion the intravenous injection of dexmetidine at 0.5 渭 g/kg 30 min before the end of operation can be used safely and effectively in adenoidectomy in children with tonsillectomy, which can make hemodynamics more stable, reduce the incidence of adverse reactions and improve the quality of recovery.
【作者單位】： 河北省秦皇島市婦幼保健院麻醉科;
【分類號(hào)】：R726.1

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