發(fā)布時間：2018-11-27 14:58

【摘要】：目的觀察右美托咪定或丙泊酚聯(lián)合七氟烷維持麻醉用于兒科手術對術后蘇醒期躁動(EA)發(fā)生的影響。方法將60例3~12歲擇期行扁桃體切除術的患兒隨機分入對照組、右美托咪定組和丙泊酚組,每組20例。麻醉誘導后以七氟烷維持麻醉,對照組靜脈注射0.9%氯化鈉溶液2mL·kg~(-1)·h~(-1),右美托咪定組在10min內靜脈注射右美托咪定1μg/kg后以1μg·kg~(-1)·h~(-1)維持,丙泊酚組靜脈注射丙泊酚2mg·kg~(-1)·h~(-1),均至手術結束前5min。記錄手術持續(xù)時間、七氟烷使用時間和拔除氣管導管的時間。采用4分評分法和兒童麻醉蘇醒期躁動(PAED)評分法評估EA發(fā)生情況。患兒4分評分法≥3分或PAED評分≥10分被認定為EA。記錄蘇醒期不良事件的發(fā)生情況。結果 3組手術持續(xù)時間和七氟烷使用時間的差異均無統(tǒng)計學意義(P值均0.05)。右美托咪定組和丙泊酚組的拔除氣管導管的時間均顯著長于對照組(P值均0.05),右美托咪定組顯著長于丙泊酚組(P0.05)。對照組4分評分法≥3分8例(40%),右美托咪定組3例(15%),丙泊酚組1例(5%);對照組PAED評分≥10分10例(50%),右美托咪定組5例(25%),丙泊酚組2例(10%)。右美托咪定組和丙泊酚組4分評分法≥3分和PAED評分≥10分的患兒比例均顯著低于對照組(P值均0.05),而右美托咪定組與丙泊酚組間差異均無統(tǒng)計學意義(P值均0.05)。3組患兒在麻醉后恢復室期間均未出現(xiàn)惡心嘔吐、喉痙攣和呼吸抑制的不良反應。結論右美托咪定或丙泊酚都能有效地抑制七氟烷麻醉術后小兒EA的發(fā)生,但丙泊酚復合七氟烷麻醉拔除氣管導管的時間更短,是臨床更為理想的選擇。
[Abstract]:Objective to observe the effect of dexmetomidine or propofol combined with sevoflurane maintenance anesthesia on restless (EA) during postoperative recovery in pediatric surgery. Methods 60 children aged from 3 to 12 were randomly divided into control group, dexmetomidine group and propofol group, with 20 cases in each group. The anesthesia was maintained with sevoflurane after anesthesia induction, and the control group was given intravenous injection of 0.9% sodium chloride solution 2mL kg~ (-1) h ~ (-1). The dexmetomidine group was treated with 1 渭 g kg~ (-1) h ~ (-1) after intravenous injection of dexmetidine 1 渭 g/kg in 10min, and propofol 2mg kg~ (-1) h ~ (-1) was injected intravenously in propofol group until 5 minutes before the end of operation. The duration of the operation, the use of sevoflurane and the time of tracheal catheter removal were recorded. The incidence of EA was evaluated by 4 score method and restless (PAED) score during anaesthesia recovery. Children with 4 score 鈮，

本文編號：2361201