右美托咪定或丙泊酚联合七氟烷维持麻醉对小儿苏醒期躁动的影响

发布时间：2018-11-27 14:58

【摘要】：目的观察右美托咪定或丙泊酚联合七氟烷维持麻醉用于儿科手术对术后苏醒期躁动(EA)发生的影响。方法将60例3~12岁择期行扁桃体切除术的患儿随机分入对照组、右美托咪定组和丙泊酚组,每组20例。麻醉诱导后以七氟烷维持麻醉,对照组静脉注射0.9%氯化钠溶液2mL·kg~(-1)·h~(-1),右美托咪定组在10min内静脉注射右美托咪定1μg/kg后以1μg·kg~(-1)·h~(-1)维持,丙泊酚组静脉注射丙泊酚2mg·kg~(-1)·h~(-1),均至手术结束前5min。记录手术持续时间、七氟烷使用时间和拔除气管导管的时间。采用4分评分法和儿童麻醉苏醒期躁动(PAED)评分法评估EA发生情况。患儿4分评分法≥3分或PAED评分≥10分被认定为EA。记录苏醒期不良事件的发生情况。结果 3组手术持续时间和七氟烷使用时间的差异均无统计学意义(P值均0.05)。右美托咪定组和丙泊酚组的拔除气管导管的时间均显著长于对照组(P值均0.05),右美托咪定组显著长于丙泊酚组(P0.05)。对照组4分评分法≥3分8例(40%),右美托咪定组3例(15%),丙泊酚组1例(5%);对照组PAED评分≥10分10例(50%),右美托咪定组5例(25%),丙泊酚组2例(10%)。右美托咪定组和丙泊酚组4分评分法≥3分和PAED评分≥10分的患儿比例均显著低于对照组(P值均0.05),而右美托咪定组与丙泊酚组间差异均无统计学意义(P值均0.05)。3组患儿在麻醉后恢复室期间均未出现恶心呕吐、喉痉挛和呼吸抑制的不良反应。结论右美托咪定或丙泊酚都能有效地抑制七氟烷麻醉术后小儿EA的发生,但丙泊酚复合七氟烷麻醉拔除气管导管的时间更短,是临床更为理想的选择。
[Abstract]:Objective to observe the effect of dexmetomidine or propofol combined with sevoflurane maintenance anesthesia on restless (EA) during postoperative recovery in pediatric surgery. Methods 60 children aged from 3 to 12 were randomly divided into control group, dexmetomidine group and propofol group, with 20 cases in each group. The anesthesia was maintained with sevoflurane after anesthesia induction, and the control group was given intravenous injection of 0.9% sodium chloride solution 2mL kg~ (-1) h ~ (-1). The dexmetomidine group was treated with 1 渭 g kg~ (-1) h ~ (-1) after intravenous injection of dexmetidine 1 渭 g/kg in 10min, and propofol 2mg kg~ (-1) h ~ (-1) was injected intravenously in propofol group until 5 minutes before the end of operation. The duration of the operation, the use of sevoflurane and the time of tracheal catheter removal were recorded. The incidence of EA was evaluated by 4 score method and restless (PAED) score during anaesthesia recovery. Children with 4 score 鈮，

本文编号：2361201