右美托咪定对小儿扁桃体腺样体切除术全身麻醉苏醒质量的影响

发布时间：2018-06-20 10:59

本文选题：右美托咪定 + 小儿　；参考：《河北医药》2016年23期

【摘要】：目的研究右美托咪定(dexmedetomidine,DEX)对小儿扁桃体腺样体切除术全身麻醉苏醒质量的影响。方法选择小儿行扁桃体腺样体切除手术患者90例,随机分为3组,每组30例。右美托咪定1组(D1组)于手术结束前30 min静脉注射右美托咪定0.5μg/kg;右美托咪定2组(D2组)于手术结束前30 min静脉注射右美托咪定1μg/kg;对照组(C组)静脉注射等容量0.9%氯化钠溶液。采用静脉快速诱导全身麻醉,术中以七氟醚复合瑞芬太尼维持麻醉。记录用药前T0,手术结束时T1,拔出气管导管即刻T2,拔管后5 min T3平均动脉压(MAP)值和心率(HR),并观察记录苏醒期不良反应(喉痉挛、恶心呕吐、躁动、苏醒延迟等)的发生情况。结果 3组患儿一般情况比较(年龄、体重)差异均无统计学意义(P0.05);3组患儿手术时间、拔管时间差异无统计学意义(P0.05),D2组苏醒时间比C组和D1组明显延长(P0.05);在T1、T2、T3时间点,D1及D2组MAP和HR值均比C组降低(P0.05);D1及D2组喉痉挛、恶心呕吐、躁动的发生率比C组明显降低(P0.05);D2组术后苏醒延迟发生率比C组和D1组明显增高(P0.05)。结论手术结束前30 min静脉注射0.5μg/kg的右美托咪定可安全有效的应用于小儿扁桃体腺样体切除术,使血流动力学更加稳定,降低不良反应的发生率,提高苏醒质量。
[Abstract]:Objective to study the effect of dexmemedetomine Dex (DEX) on the recovery quality of general anesthesia after tonsillectomy in children. Methods 90 children with tonsillectomy were randomly divided into 3 groups, 30 cases in each group. Dexmetomidine group 1 (group D 1): dexmetomidine 0.5 渭 g / kg intravenously 30 min before operation; dexmetomidine group 2 (group D 2) intravenous injection of dexmetomidine 1 渭 g / kg 30 min before operation; control group C) 0.9% sodium chloride solution intravenously. General anesthesia was induced by intravenous fast induction, and sevoflurane combined with remifentanil was used to maintain anesthesia. The values of T _ 0, T _ 1 at the end of operation, T _ 2 immediately after tracheal catheter extraction, mean arterial pressure at 5 min after extubation and heart rate were recorded, and the occurrence of adverse reactions (laryngeal spasm, nausea and vomiting, restlessness, delayed recovery, etc.) was observed. Results there was no significant difference in general conditions (age, body weight) among the three groups. There was no significant difference in extubation time between group D 2 and group C and group D1, map and HR values in group D 1 and group D 2 were significantly lower than those in group C and group D 2. The incidence of restlessness in group D 2 was significantly lower than that in group C (P 0.05) and the incidence of delayed postoperative recovery in group D 2 was significantly higher than that in group C and group D1. Conclusion the intravenous injection of dexmetidine at 0.5 渭 g/kg 30 min before the end of operation can be used safely and effectively in adenoidectomy in children with tonsillectomy, which can make hemodynamics more stable, reduce the incidence of adverse reactions and improve the quality of recovery.
【作者单位】：河北省秦皇岛市妇幼保健院麻醉科;
【分类号】：R726.1

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