【摘要】：目的探討帕瑞昔布鈉聯(lián)合右美托咪定預(yù)防小兒全身麻醉蘇醒期不良反應(yīng)的臨床效果。方法將60例行扁桃體剝離合并腺樣體吸切手術(shù)的全身麻醉患兒按隨機(jī)數(shù)字表法分為3組:帕瑞昔布鈉聯(lián)合右美托咪定組(PD組)、右美托咪定組(D組)、生理鹽水組(C組),每組20例。3組均行七氟烷吸入全身麻醉,手術(shù)結(jié)束前5min PD組靜脈注射1mg·kg~(-1)帕瑞昔布鈉,微量泵輸注0.5μg·kg~(-1)右美托咪定20mL;D組微量泵輸注0.5μg·kg~(-1)右美托咪定20mL;C組微量泵輸注生理鹽水20mL。記錄基礎(chǔ)狀態(tài)(T0),拔管前1min(T1),拔管時(shí)(T2),拔管后1min(T3)、5min(T4)、15min(T5)、30min(T6)及60min(T7)時(shí)MAP、HR、SpO_2,并進(jìn)行兒童麻醉后躁動(dòng)評(píng)分(PAED)、Ramsay鎮(zhèn)靜評(píng)分、改良加拿大東安大略?xún)和t(yī)院疼痛評(píng)分(m-CHEOPS)。記錄拔管前后咳嗽、躁動(dòng)例數(shù)及呼吸恢復(fù)時(shí)間、喚醒時(shí)間、拔管時(shí)間。結(jié)果 3組MAP、HR T0時(shí)點(diǎn)比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);其余各時(shí)點(diǎn)C組均高于D組、DP組,D組高于DP組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。PAED評(píng)分T4—T6時(shí)點(diǎn)C組高于PD組、D組,D組高于DP組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);Ramsay評(píng)分T4—T7時(shí)點(diǎn)C組低于DP組、D組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);m-CHEOPS評(píng)分T4—T7時(shí)點(diǎn)C組高于DP組、D組,D組高于DP組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。3組患兒蘇醒時(shí)間、拔管時(shí)間、呼吸恢復(fù)時(shí)間比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);咳嗽發(fā)生率C組高于DP組和D組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);躁動(dòng)發(fā)生率C組高于DP組和D組,D組高于DP組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論帕瑞昔布鈉聯(lián)合右美托咪定能降低扁桃體剝離合并腺樣體吸切手術(shù)全身麻醉患兒蘇醒期躁動(dòng)、咳嗽發(fā)生率,血流動(dòng)力學(xué)平穩(wěn)而且不延長(zhǎng)拔管、蘇醒時(shí)間。
[Abstract]:Objective to investigate the clinical effect of paroxib sodium combined with dexmetomidine in the prevention of adverse reactions during recovery of general anesthesia in children. Methods Sixty children undergoing general anesthesia with tonsillectomy and adenoidectomy were randomly divided into 3 groups: paroxib sodium combined with dexmetomidine (PD group), dexmetomidine group (D group) and normal saline group (normal saline group). Each group (20 cases) received sevoflurane inhalation general anesthesia. Before operation, 1mg kg~ (-1) paroxib sodium was injected intravenously into 5min PD group, and 0.5 渭 g kg~ (-1) dexmetomidine 20mLL was infused by micropump in group D (0.5 渭 g kg~ (-1), and normal saline 20mL was injected into group C by micropump infusion of dexmetomidine (20mLL). The basic state (T0), 1min (T1) before extubation, extubation (T2), 1min (T3) 5min (T4) after extubation, 30min (T6) and 60min (T7) were recorded. The restlessness scale (PAED) Ramsay sedation score after anesthesia was performed, and the pain score (m-CHEOPS) of children's hospital in Eastern Ontario, Canada was improved. The number of cough, restlessness, respiratory recovery time, arousal time and extubation time were recorded before and after extubation. Results there was no significant difference in MAP,HR T0 time points among the three groups (P0.05), and the other time points in group C were higher than those in group D (P 0.05), and the difference was statistically significant (P 0.05). The T4-T6 score of group C was higher than that of group D (P 0.05), and that of group D was higher than that of group D (P 0.05), and that of group D was higher than that of group D (P 0.05). The difference was statistically significant (P0.05) the T4-T7 score in group C was lower than that in group D in DP group (P0.05), and the difference was statistically significant (P0.05). The score of T4-T7 time point in group C was higher than that in group DP group D and that in group D was higher than that in group DP. The difference was statistically significant (P0.05) in the recovery time of children in group C (P0.05). There was no significant difference in extubation time and respiratory recovery time (P0.05); the incidence of cough in group C was higher than that in group DP and group D (P0.05); the incidence of restlessness in group C was higher than that in group DP and group D was higher than that in group DP (P0.05). The difference was statistically significant (P0.05). Conclusion paroxib sodium combined with dexmetomidine can reduce restlessness, cough, hemodynamics, extubation and recovery time in children with general anesthesia after tonsillectomy and adenoidectomy.
【作者單位】： 惠州市第六人民醫(yī)院麻醉科;
【基金】：惠州市科技計(jì)劃項(xiàng)目基金(2014Y203)
【分類(lèi)號(hào)】：R726.1

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