帕瑞昔布钠联合右美托咪定预防小儿全身麻醉苏醒期不良反应的效果

发布时间：2018-09-03 13:00

【摘要】：目的探讨帕瑞昔布钠联合右美托咪定预防小儿全身麻醉苏醒期不良反应的临床效果。方法将60例行扁桃体剥离合并腺样体吸切手术的全身麻醉患儿按随机数字表法分为3组:帕瑞昔布钠联合右美托咪定组(PD组)、右美托咪定组(D组)、生理盐水组(C组),每组20例。3组均行七氟烷吸入全身麻醉,手术结束前5min PD组静脉注射1mg·kg~(-1)帕瑞昔布钠,微量泵输注0.5μg·kg~(-1)右美托咪定20mL;D组微量泵输注0.5μg·kg~(-1)右美托咪定20mL;C组微量泵输注生理盐水20mL。记录基础状态(T0),拔管前1min(T1),拔管时(T2),拔管后1min(T3)、5min(T4)、15min(T5)、30min(T6)及60min(T7)时MAP、HR、SpO_2,并进行儿童麻醉后躁动评分(PAED)、Ramsay镇静评分、改良加拿大东安大略儿童医院疼痛评分(m-CHEOPS)。记录拔管前后咳嗽、躁动例数及呼吸恢复时间、唤醒时间、拔管时间。结果 3组MAP、HR T0时点比较差异均无统计学意义(P0.05);其余各时点C组均高于D组、DP组,D组高于DP组,差异均有统计学意义(P0.05)。PAED评分T4—T6时点C组高于PD组、D组,D组高于DP组,差异均有统计学意义(P0.05);Ramsay评分T4—T7时点C组低于DP组、D组,差异均有统计学意义(P0.05);m-CHEOPS评分T4—T7时点C组高于DP组、D组,D组高于DP组,差异均有统计学意义(P0.05)。3组患儿苏醒时间、拔管时间、呼吸恢复时间比较差异均无统计学意义(P0.05);咳嗽发生率C组高于DP组和D组,差异有统计学意义(P0.05);躁动发生率C组高于DP组和D组,D组高于DP组,差异均有统计学意义(P0.05)。结论帕瑞昔布钠联合右美托咪定能降低扁桃体剥离合并腺样体吸切手术全身麻醉患儿苏醒期躁动、咳嗽发生率,血流动力学平稳而且不延长拔管、苏醒时间。
[Abstract]:Objective to investigate the clinical effect of paroxib sodium combined with dexmetomidine in the prevention of adverse reactions during recovery of general anesthesia in children. Methods Sixty children undergoing general anesthesia with tonsillectomy and adenoidectomy were randomly divided into 3 groups: paroxib sodium combined with dexmetomidine (PD group), dexmetomidine group (D group) and normal saline group (normal saline group). Each group (20 cases) received sevoflurane inhalation general anesthesia. Before operation, 1mg kg~ (-1) paroxib sodium was injected intravenously into 5min PD group, and 0.5 渭 g kg~ (-1) dexmetomidine 20mLL was infused by micropump in group D (0.5 渭 g kg~ (-1), and normal saline 20mL was injected into group C by micropump infusion of dexmetomidine (20mLL). The basic state (T0), 1min (T1) before extubation, extubation (T2), 1min (T3) 5min (T4) after extubation, 30min (T6) and 60min (T7) were recorded. The restlessness scale (PAED) Ramsay sedation score after anesthesia was performed, and the pain score (m-CHEOPS) of children's hospital in Eastern Ontario, Canada was improved. The number of cough, restlessness, respiratory recovery time, arousal time and extubation time were recorded before and after extubation. Results there was no significant difference in MAP,HR T0 time points among the three groups (P0.05), and the other time points in group C were higher than those in group D (P 0.05), and the difference was statistically significant (P 0.05). The T4-T6 score of group C was higher than that of group D (P 0.05), and that of group D was higher than that of group D (P 0.05), and that of group D was higher than that of group D (P 0.05). The difference was statistically significant (P0.05) the T4-T7 score in group C was lower than that in group D in DP group (P0.05), and the difference was statistically significant (P0.05). The score of T4-T7 time point in group C was higher than that in group DP group D and that in group D was higher than that in group DP. The difference was statistically significant (P0.05) in the recovery time of children in group C (P0.05). There was no significant difference in extubation time and respiratory recovery time (P0.05); the incidence of cough in group C was higher than that in group DP and group D (P0.05); the incidence of restlessness in group C was higher than that in group DP and group D was higher than that in group DP (P0.05). The difference was statistically significant (P0.05). Conclusion paroxib sodium combined with dexmetomidine can reduce restlessness, cough, hemodynamics, extubation and recovery time in children with general anesthesia after tonsillectomy and adenoidectomy.
【作者单位】：惠州市第六人民医院麻醉科;
【基金】：惠州市科技计划项目基金(2014Y203)
【分类号】：R726.1

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