右美托咪定对小儿七氟醚麻醉术后恶心呕吐及躁动的影响

发布时间：2018-09-12 14:58

【摘要】：目的 :比较右美托咪定和氯胺酮对小儿七氟醚麻醉术后恶心呕吐与躁动的影响。方法 :择期行疝囊高位结扎术的患儿92例,随机分为氯胺酮组(K组)和右美托咪定组(D组),每组46例。入室后K组静注氯胺酮1.0 mg/kg,D组静脉泵入右美托咪定1.0μg/kg,入睡后七氟醚诱导及术中维持。分别记录麻醉前(T0)、手术开始后5 min(T1)、手术结束时(T2)的心率(heart rate,HR)、氧饱和度(Sp O2);观察并记录术中体动发生率、苏醒时间及恢复室停留时间、恶心呕吐、躁动不良反应发生的情况及出恢复室的Steward苏醒评分。结果:与T0时比较,K组T1、T2时的HR上升,差异有统计学意义(P0.05)。与T0时比较,D组T1时段的HR下降、T2时段的HR上升,差异有统计学意义(P0.05)。T1、T2时D组HR低于K组,差异有统计学意义(P0.05)。D组术后躁动及恶心呕吐等不良反应发生率少于K组。两组术中体动发生率、苏醒时间和恢复室停留时间差异无统计学意义。结论:小儿行疝囊高位结扎术七氟醚麻醉前,与静脉注射1.0 mg/kg氯胺酮比较,静脉泵入右美托咪定1.0μg/kg可降低术后恶心呕吐及躁动的发生,且不延长苏醒时间和恢复室停留时间。
[Abstract]:Aim: to compare the effects of dexmetidine and ketamine on nausea, vomiting and restlessness after sevoflurane anesthesia in children. Methods: Ninety-two children with selective high ligation of hernia sac were randomly divided into ketamine group (group K) and dexmetomidine group (group D) with 46 cases in each group. In group K, intravenous injection of ketamine 1.0 mg/kg,D was performed with dexmetomidine 1.0 渭 g / kg, sevoflurane induction and intraoperative maintenance. The heart rate (heart rate,HR) and oxygen saturation (Sp O2) were recorded before anesthesia (T0), 5 min (T1) after operation and at the end of operation (T2). Adverse events of restlessness and Steward recovery score of recovery chamber. Results: compared with T _ 0, the HR of T _ 1 and T _ 2 in K group was significantly higher than that in T _ 0 group (P 0.05). Compared with T0, the HR of group D decreased at T1 and increased at T2, the difference was statistically significant (P0.05). The HR of group D was lower than that of group K at T2 (P0.05). The incidence of adverse reactions such as restlessness and nausea and vomiting in group D was lower than that in group K (P0.05). There was no significant difference between the two groups in the incidence of body movement, recovery time and recovery time. Conclusion: before sevoflurane anesthesia for high ligation of hernia sac, intravenous infusion of dexmetidine 1.0 渭 g/kg can reduce the incidence of nausea, vomiting and restlessness, and does not prolong the recovery time and residence time.
【作者单位】：南京医科大学第二附属医院麻醉科;
【分类号】：R726.1

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