右美托咪啶对小儿心导管术全麻及苏醒质量的影响

发布时间：2018-05-08 17:55

本文选题：右美托咪啶 + 儿童　；参考：《中国临床药理学杂志》2015年05期

【摘要】：目的观察右美托咪啶对小儿心导管术麻醉维持和苏醒质量的影响。方法将择期进行心导管术的1~11岁儿童随机分为右美托咪啶复合七氟烷组(DS组)41例和七氟烷组(S组)43例。所有患儿均于入室后,静脉注射氯胺酮1 mg·kg-1。DS组静脉泵持续10 min输入复合量的右美托咪啶1μg·kg-1,术中再予维持量2μg·kg-1·h-1,S组用0.9%氯化钠代替。2组术中用脑电双频谱指数(BIS)监测麻醉深度,通过调节七氟烷吸入浓度使BIS值维持在55~65之间。记录2组患儿入室时(T0)、喉罩置入即刻(T1)、喉罩置入后20 min(T2)、喉罩拔除即刻(T3)各时点的心率、平均动脉压、呼吸频率、BIS值、呼气末二氧化碳分压及呼气末七氟烷浓度,记录手术时间、苏醒时间、术后镇静药使用情况及呼吸抑制、恶心、呕吐等不良反应的发生。结果 T1~T3各时点的DS组心率明显低于S组(P0.01)。T2、T3时点,DS组呼气末七氟烷浓度明显低于S组(P0.01)。DS组术后苏醒时间明显长于S组(P0.01)。初醒时点,DS组镇静躁动评分明显低于S组(P0.01)。术后,DS组躁动需加镇静药例数(12例)明显少于S组(37例),2组比较差异有统计学意义(P0.01)。结论右美托咪啶能优化小儿心导管术的麻醉维持和苏醒质量。
[Abstract]:Objective to observe the effect of dexmetidine on maintenance and recovery of anesthesia in pediatric cardiac catheterization. Methods the 11 year old children who underwent cardiac catheterization were randomly divided into desmetomidine combined sevoflurane group (n = 41) and sevoflurane group (n = 41) and sevoflurane group (n = 43). All the children were injected intravenously with ketamine 1 mg kg-1.DS for 10 min with dexmetidine 1 渭 g kg-1. the intraoperative maintenance 2 渭 g kg-1 h-1s group was given 0.9% sodium chloride instead of 0.9% sodium chloride to monitor the anesthetic depth during the operation of group 2. 2 (bispectral index of EEG) was used to monitor the anesthetic depth. By adjusting sevoflurane inhalation concentrations, BIS levels remain between 55 and 65. The heart rate, mean arterial pressure, respiratory frequency and BIS, end-expiratory partial pressure of CO _ 2 and concentration of end-expiratory sevoflurane were recorded at 20 min after laryngeal mask implantation and 20 min after laryngeal mask implantation, and the mean arterial pressure, BIS value, end-expiratory partial pressure and end-expiratory sevoflurane concentration were recorded. Recovery time, postoperative sedative use and respiratory inhibition, nausea, vomiting and other adverse reactions. Results the heart rate of DS group at each time point of T1~T3 was significantly lower than that of S group (P 0.01). T2 + T 3 was significantly lower than that of group S (P 0.01). The recovery time of group DS was significantly longer than that of group S (P 0.01). The sedative restlessness score of DS group was significantly lower than that of S group (P 0.01). There were 12 cases of restlessness and sedation needed in DS group after operation, which were significantly less than those in group S (37 cases) and the difference was statistically significant (P 0.01). Conclusion dexmetidine can optimize the anesthesia maintenance and recovery quality of pediatric cardiac catheterization.
【作者单位】：温州医科大学附属第二医院麻醉科;温州医科大学附属第二医院小儿心内科;
【基金】：浙江省自然基金资助项目(Y2110380) 温州市科技局项目(Y20130130)
【分类号】：R726.1

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