右美托咪定预防儿童全麻苏醒期躁动和谵妄的安全有效剂量

发布时间：2018-04-15 08:22

本文选题：右美托咪定 + 儿童　；参考：《广东医学》2017年11期

【摘要】：目的探讨右美托咪定预防儿童全麻苏醒期躁动和谵妄的安全有效剂量。方法选取择期行全麻下腹腔镜下疝囊高位结扎术的患儿120例,随机分为4组,A、B、C组患儿分别经静脉恒速(60 m L/h)泵注0.25、0.5和1μg/kg右美托咪定,D组(对照组)以相同的速度泵入生理盐水。对比4组患儿的5点评分量表评分和苏醒期谵妄(ED)和躁动(EA)发生率。比较4组患儿的儿童和婴儿术后疼痛评分(CHIPPS评分),记录七氟烷的用量及手术时间(TO),停止麻醉药物至拔喉罩时间(TM)、自主睁眼时间(TE),记录患儿在麻醉后监护室停留的时间(TP)。结果 4组患儿TO比较差异无统计学意义(P0.05),其中B、C组TM显著高于A、D组(P0.05),C组显著高于B组(P0.05);其中A、B、D三组的TE和TP比较差异无统计学意义(P0.05),C组TE显著高于A、B、D三组(P0.05);而C组TP显著高于A、D组(P0.05),而B、C两组的TP比较差异无统计学意义(P0.05);A、B、C三组的5点评分量表评分、EA和ED发生率均显著低于D组(P0.05),3项指标中B、C组均显著低于A组(P0.05),B、C组之间差异无统计学意义(P0.05);A、B、C三组的CHIPPS评分和七氟烷的用量均显著低于D组(P0.05),而B、C组显著低于A组(P0.05),B、C组之间差异无统计学意义(P0.05)。结论儿童全麻中使用右美托咪定0.5μg/kg的剂量可安全有效地预防患儿手术后苏醒期躁动和谵妄,能减少术中七氟烷用量及减轻术后疼痛。
[Abstract]:Objective to investigate the safe and effective dose of dexmetomidine in preventing restlessness and delirium during general anesthesia in children.Methods one hundred and twenty children undergoing laparoscopic high ligation of hernia sac under general anesthesia were randomly divided into 4 groups: group A (n = 4) were injected intravenously with constant velocity of 60 mL / h and group D (n = 1 渭 g/kg) were pumped into normal saline at the same speed.The five-point rating scale (5-score) and the incidence of delirium (EDV) and restlessness (EAA) in the recovery period were compared among the 4 groups.The postoperative pain scores of children and infants in the four groups were compared, the dosage of sevoflurane and the time of operation were recorded, the time of stopping anaesthesia to larynx mask and the time of spontaneous eye opening were recorded, and the time of staying in the intensive care unit after anesthesia was recorded.Results there was no significant difference in to between the four groups, among which TM in group B was significantly higher than that in group B (P 0.05), and the te and TP in group A were significantly higher than that in group B (P 0.05). There was no significant difference in te and TP between group C and group C (P 0.05), but that in group C was significantly higher than that in group ABD (P 0.05), while in group B (P 0.05), there was no significant difference between group A (P 0.05) and group C (P 0.05), and there was no significant difference between group B (P 0.05) and group C (P 0.05).TP in group C was significantly higher than that in group A (P 0.05), but there was no significant difference in TP between the two groups. The scores of EA and Ed in group C were significantly lower than those in group D (P 0.05) and the incidence of Ed in group B was significantly lower than that in group A (P 0.05) and the incidence of Ed in group C was significantly lower than that in group A (P 0.05) and the incidence of Ed in group C was significantly lower than that in group A (P 0.05) and the incidence of Ed in group C was significantly lower than that in group A (P 0.05).The CHIPPS score and sevoflurane dosage of P0.05An BHG C group were significantly lower than that of D group (P 0.05), while the BHG C group was significantly lower than that of A group (P 0.05) BHG group. There was no significant difference (P 0.05) between group A and group B (P < 0.05), but there was no significant difference between group A (P 0.05) and group A (P 0.05).Conclusion the dose of dexmetomidine 0.5 渭 g/kg in children with general anesthesia can prevent restlessness and delirium during postoperative recovery, reduce the dosage of sevoflurane during operation and relieve postoperative pain.
【作者单位】：佛山市妇幼保健院麻醉科;佛山市妇幼保健院新生儿科;
【分类号】：R726.1

【相似文献】