右美托咪啶口服对小儿扁桃体术前术后镇静镇痛效果探讨

发布时间：2018-01-30 19:00

本文关键词： 右旋美托咪啶扁桃体切除术镇静镇痛术后躁动　出处：《临床医药文献电子杂志》2016年46期 　论文类型：期刊论文

【摘要】：目的探讨口服右旋美托咪啶对小儿扁桃体切除术前镇静、术后镇静、镇痛、急性躁动的效果。方法选择我院2013年9月~2014年9月收治扁桃体切除术患儿80例作为研究对象,80例ASA I-II级行扁桃体手术的患儿,随机分为对照组(C组)和右美托咪定组(D组),各40例,D组术前1 h口服含有2.5μg/kg右美托咪定糖浆10 m L,C组术前1 h口服10 m L糖浆,麻醉诱导采用丙泊酚1~2 mg/kg、罗库溴铵0.6 mg/kg、芬太尼2μg/kg,病人术中以2%七氟醚、6~10μg/kg/h瑞芬太尼维持,手术结束停止吸入七氟醚和瑞芬太尼泵人,静推1 mg/kg氟比洛芬酯。观察记录患儿不同时间点血流动力学的指标及服药后30 min时的镇静评分、与父母分离时的情绪状态以及麻醉结束至睁眼时间。结果两组患儿在年龄、体重、性别比及手术时间等指标上的比较,差异无统计学意义(P0.05)。D组T1时HR明显下降,D组在T1-T5时MAP及HR均较C组低,尤其是T4和T5两个时间点,差异有统计学意义(P0.05)。C组和D组RSS评分分别为(2.5±0.5)和(2.7±0.5),差异无显著差异(P0.05)。C组的首次睁眼时间是(8.5±4.0)min,D组的为(9.2±5.0)min,两组无显著差异(P0.05)。C组病人躁动的发生率为36%,D组病人的发生率为16%,两组相比有显著差异(P0.05)。结论口服右旋美托咪啶可有效预防小儿扁桃体术后急性躁动。
[Abstract]:Objective to investigate the effect of oral dexmetidine on sedation, postoperative sedation and analgesia in children after tonsillectomy. Methods from September 2013 to September 2014, 80 children with tonsillectomy were selected. 80 children with ASA I-II grade tonsillectomy were randomly divided into control group (n = 40) and dexmetomidine group (n = 40). In group D, 2.5 渭 g / kg dexmetomidine syrup was given 1 hour before operation. In group C, 10 mL syrup was given 1 hour before operation. Propofol was used for 2 mg/kg. Rocuronium 0.6 mg / kg, fentanyl 2 渭 g / kg, 2% sevoflurane 6 渭 g / kg / h remifentanil. Sevoflurane and remifentanil were administered at the end of the operation by intravenous injection of flurbiprofen ester for 1 mg/kg. Hemodynamic indexes at different time points and sedation score at 30 min after treatment were recorded. Results the age, weight, sex ratio and operation time were compared between the two groups. There was no significant difference in HR at T1 in group P0.05. The MAP and HR in group D were lower than those in group C at T1-T5, especially at T4 and T5. The RSS scores of group C and D were 2.5 卤0.5 and 2.7 卤0.5 respectively. There was no significant difference in the first time of eye opening in P0.05U 路C group (8.5 卤4.0 min). The time of eye opening in group D was 9.2 卤5.0 minutes. There was no significant difference between the two groups in the incidence of restlessness in group P0.05. C was 16% in group D and 36 in group D. Conclusion the oral administration of dexmetidine can effectively prevent acute restlessness after tonsillectomy in children.
【作者单位】：泰安市中心医院麻醉科;
【分类号】：R726.1
【正文快照】： 术前焦虑、恐惧,与父母分离困难,术后伴随急性疼痛躁动是小儿扁桃体手术经常遇到的难题,严重影响患儿及父母的情绪,影响麻醉及苏醒质量,增加术后出血的几率,降低患者及家属的满意度[1],如何能采取一种既让患儿容易接受,又能有效减轻术后急性疼痛和躁动的方法,从而改善麻醉苏醒

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