【摘要】：目的探討右美托咪啶對全麻患兒生命體征、七氟烷用量和術(shù)后躁動、惡心嘔吐發(fā)生率的影響。方法選擇四肢骨折愈合后手術(shù)取內(nèi)固定3~10歲小兒60例,隨機(jī)分為觀察組和對照組各30例。觀察組在七氟烷誘導(dǎo)前給予右美托咪啶0.5μg/kg于15 min內(nèi)泵入,術(shù)中用0.2μg/(kg·h)泵入,在手術(shù)結(jié)束前0.5 h停藥;對照組給予等量生理鹽水。兩組手術(shù)中均用麻醉深度監(jiān)測儀監(jiān)測麻醉深度,調(diào)整七氟烷濃度使腦電雙頻譜指數(shù)(BIS)控制在40~50。觀察兩組泵入右美托咪啶或生理鹽水之前(T_0)、給予右美托咪啶或生理鹽水15 min時(T_1)、插喉罩時(T_2)、手術(shù)開始(T_3)、手術(shù)10 min(T_4)、手術(shù)30 min(T_5)、手術(shù)結(jié)束時(T_6)各時間點(diǎn)的血壓(SBP、DBP)、心率(HR)、BIS變化。比較兩組術(shù)中七氟烷的用量、麻醉誘導(dǎo)時間、停藥后清醒時間、蘇醒時躁動程度及惡心嘔吐發(fā)生情況。結(jié)果觀察組SBP、DBP、HR在T_1~T_6多個時間點(diǎn)低于對照組(P均0.05),但均控制在正常范圍。與對照組相比,觀察組麻醉誘導(dǎo)時間縮短,七氟烷用量減少,躁動、惡心嘔吐發(fā)生率降低,差異均有統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論右美托咪啶能減少全麻患兒七氟烷用量,降低患兒術(shù)后躁動、惡心嘔吐發(fā)生率,且對患兒SBP、DBP、HR無明顯影響。
[Abstract]:Objective to investigate the effects of dexmetidine on vital signs, sevoflurane dosage and postoperative restlessness, nausea and vomiting in children with general anesthesia. Methods 60 cases of 10 years old children with internal fixation after fracture healing were randomly divided into two groups: 30 cases in the observation group and 30 cases in the control group. Before sevoflurane induction, the observation group was injected with dexmetidine 0.5 渭 g/kg for 15 min, and 0.2 渭 g / (kg h) was pumped in during the operation and stopped at 0.5 h before the end of the operation, while the control group was given the same amount of normal saline. Anesthetic depth monitor was used to monitor the anesthetic depth in both groups and the bispectral index (BIS) of EEG was controlled at 40 ~ 50 by adjusting the concentration of sevoflurane. Before the two groups were pumped into dexmetidine or normal saline (T _ s _ 0), the two groups were given dexmetomidine or normal saline for 15 min (T _ 1), the larynx mask (T _ 2), the operation began (T _ 3), and the operation was 10 min (T _ 4). The changes of blood pressure (SBP,DBP) and heart rate (HR), BIS) were observed at 30 min (T _ 5) and at the end of operation (T _ 6). The dosage of sevoflurane during operation, the induction time of anesthesia, the waking time after withdrawal, the restlessness during recovery and the incidence of nausea and vomiting were compared between the two groups. Results the SBP,DBP,HR of the observation group was lower than that of the control group at multiple time points of T_1~T_6 (all P 0. 05), but it was controlled in the normal range. Compared with the control group, the anesthetic induction time was shortened, the dosage of sevoflurane was decreased, the incidence of restlessness and nausea and vomiting were decreased in the observation group (all P 0.05). Conclusion dexmetidine can reduce sevoflurane consumption and reduce postoperative restlessness, nausea and vomiting in children with general anesthesia, and has no significant effect on SBP,DBP,HR in children.
【作者單位】： 西南醫(yī)科大學(xué)附屬中醫(yī)醫(yī)院;內(nèi)江市市中區(qū)婦幼保健院;內(nèi)江市第二人民醫(yī)院;
【基金】：四川省科技廳、瀘州市人民政府、瀘州醫(yī)學(xué)院合作項(xiàng)目(14JC0173)
【分類號】：R726.1

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