不同剂量右美托咪啶预防小儿苏醒期躁动的临床效果

发布时间：2017-12-31 06:19

本文关键词：不同剂量右美托咪啶预防小儿苏醒期躁动的临床效果　出处：《延边大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的观察不同剂量右美托咪啶减少术后躁动发生率的效果,为临床选择适宜的剂量提供参考依据。方法随机选取同时行扁桃体和腺样体切除3～6岁小儿60例,随机分为A组泵注右美托咪啶1ug/kg,B组泵注右美托咪啶0.5ug/kg,C组泵注盐水组,每组20例。监测和记录入PACU(T1)、拔管前(T2)、拔管时(T3)等时刻的MAP、HR变化情况;对全麻苏醒期躁动情况进行评分、且统计出躁动的发生比例、记录相关麻醉时间,将所得数据通过五级躁动评分表进行评分处理(4分躁动);观察研究对象在苏醒时间、躁动发生情况和严重性,且对呕吐、呛咳等反应进行观察和记录;记录拔除气管四小时内的镇静程度评分(判断是否满足镇静要求)。结果(1)C组患儿全麻苏醒期间躁动发生率(16例,80%)明显高于A组(2例,10%)和B组(6例,30%),三组间比较有统计学差异(P0.05)(2)A组(拔管时MAP80±13HR98±13,拔管后MAP82±11HR96±12)和8组(拔管时MA82±12 HR 108±14,拔管后MAP 83±10 HR 106±13)患儿在苏醒拔管时、拔管后血流动力学较C组(拔管时MAP 94±12 HR 128±20,拔管后MAP 97±14 HR 130±21)更为平稳,有统计学差异(P0.05)。(3)与C组(拔管后1h0.7±0.4、2h1.1±0.5、3h1.5±0.4、4h1.6±0.7)相比,A组(拔管后 1h 1.5±0.5、2h 1.9±0.4、3h 2.3±0.7、4h 2.8±0.6)和 B 组(拔管后 1h 1.3±0.8、2h 1.6±0.4、3h1.7±0.3、4h2.2±0.4)拔管后 1～4hRamsay 镇静评分高,,有统计学差异(P0.05)。结论在全麻诱导时泵注右美托咪啶可有效降低小儿扁桃体、腺样体切除术后躁动发生率,拔管期间血流动力学更平稳、术后4小时安静睡眠率高,且泵注右美托咪啶高剂量组效果更佳。
[Abstract]:Objective to observe the effect of different doses of dexmetidine on the reduction of postoperative restlessness. Methods 60 children aged 3 to 6 years old who underwent tonsillectomy and adenoidectomy were randomly divided into two groups: group A: right metomidine 1 ug-1 / kg by pump. Group B was injected with dexmetidine 0.5ug- kg ~ (-1) in saline group (n = 20). The MAP was monitored and recorded in PACUT _ (1), T _ (2) before extubation, and T _ (3) during extubation. HR changes; The restlessness during the general anesthesia recovery period was scored, and the occurrence ratio of restlessness was calculated, and the relevant anesthetic time was recorded, and the data were graded through the five-grade restlessness score table (4 minutes restlessness). The subjects were observed and recorded in the recovery time, the occurrence and severity of restlessness, and the responses to vomiting and cough. The score of sedation degree within 4 hours after tracheal extubation (to judge whether the sedation requirement was satisfied or not) was significantly higher in group C than in group A (n = 16, n = 80) during general anesthesia recovery, and was significantly higher than that in group A (n = 2). There was significant difference between group B and group B (MAP80 卤13HR98 卤13). After extubation, MAP82 卤11HR96 卤12) and group 8 (MA82 卤12 HR108 卤14 at extubation). The hemodynamics after extubation in MAP 83 卤10 HR 106 卤13) was higher than that in C group (MAP 94 卤12 HR 128 卤20 at extubation). After extubation, MAP (97 卤14 HR, 130 卤21) was more stable, there was statistical difference between group C and group C (0. 7 卤0. 4 at 1h after extubation). 2h1.1 卤0.5h1.5 卤0.4h1.6 卤0.7) compared with group A (1.5 卤0.5h2h after extubation, 1.9 卤0.4). 3 h 2.3 卤0.7 h 2.8 卤0.6) and B group (1 h 1.3 卤0.82 h 1.6 卤0.4 h 1.7 卤0.3). 4 h 2.2 卤0.4) Ramsay sedation score was high at 1h and 4h after extubation. There was a significant difference (P 0.05). Conclusion pump injection of dexmetidine can effectively reduce the incidence of restlessness after adenoidectomy during general anesthesia induction, and the hemodynamics is more stable during extubation. The rest sleep rate was high 4 hours after operation, and the effect of high dose dexmemetidine was better.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.1

【参考文献】