右美托咪啶对全麻患儿生命体征、七氟烷用量及术后不良反应的影响

发布时间：2019-01-06 16:33

【摘要】：目的探讨右美托咪啶对全麻患儿生命体征、七氟烷用量和术后躁动、恶心呕吐发生率的影响。方法选择四肢骨折愈合后手术取内固定3~10岁小儿60例,随机分为观察组和对照组各30例。观察组在七氟烷诱导前给予右美托咪啶0.5μg/kg于15 min内泵入,术中用0.2μg/(kg·h)泵入,在手术结束前0.5 h停药;对照组给予等量生理盐水。两组手术中均用麻醉深度监测仪监测麻醉深度,调整七氟烷浓度使脑电双频谱指数(BIS)控制在40~50。观察两组泵入右美托咪啶或生理盐水之前(T_0)、给予右美托咪啶或生理盐水15 min时(T_1)、插喉罩时(T_2)、手术开始(T_3)、手术10 min(T_4)、手术30 min(T_5)、手术结束时(T_6)各时间点的血压(SBP、DBP)、心率(HR)、BIS变化。比较两组术中七氟烷的用量、麻醉诱导时间、停药后清醒时间、苏醒时躁动程度及恶心呕吐发生情况。结果观察组SBP、DBP、HR在T_1~T_6多个时间点低于对照组(P均0.05),但均控制在正常范围。与对照组相比,观察组麻醉诱导时间缩短,七氟烷用量减少,躁动、恶心呕吐发生率降低,差异均有统计学意义(P均0.05)。结论右美托咪啶能减少全麻患儿七氟烷用量,降低患儿术后躁动、恶心呕吐发生率,且对患儿SBP、DBP、HR无明显影响。
[Abstract]:Objective to investigate the effects of dexmetidine on vital signs, sevoflurane dosage and postoperative restlessness, nausea and vomiting in children with general anesthesia. Methods 60 cases of 10 years old children with internal fixation after fracture healing were randomly divided into two groups: 30 cases in the observation group and 30 cases in the control group. Before sevoflurane induction, the observation group was injected with dexmetidine 0.5 渭 g/kg for 15 min, and 0.2 渭 g / (kg h) was pumped in during the operation and stopped at 0.5 h before the end of the operation, while the control group was given the same amount of normal saline. Anesthetic depth monitor was used to monitor the anesthetic depth in both groups and the bispectral index (BIS) of EEG was controlled at 40 ~ 50 by adjusting the concentration of sevoflurane. Before the two groups were pumped into dexmetidine or normal saline (T _ s _ 0), the two groups were given dexmetomidine or normal saline for 15 min (T _ 1), the larynx mask (T _ 2), the operation began (T _ 3), and the operation was 10 min (T _ 4). The changes of blood pressure (SBP,DBP) and heart rate (HR), BIS) were observed at 30 min (T _ 5) and at the end of operation (T _ 6). The dosage of sevoflurane during operation, the induction time of anesthesia, the waking time after withdrawal, the restlessness during recovery and the incidence of nausea and vomiting were compared between the two groups. Results the SBP,DBP,HR of the observation group was lower than that of the control group at multiple time points of T_1~T_6 (all P 0. 05), but it was controlled in the normal range. Compared with the control group, the anesthetic induction time was shortened, the dosage of sevoflurane was decreased, the incidence of restlessness and nausea and vomiting were decreased in the observation group (all P 0.05). Conclusion dexmetidine can reduce sevoflurane consumption and reduce postoperative restlessness, nausea and vomiting in children with general anesthesia, and has no significant effect on SBP,DBP,HR in children.
【作者单位】：西南医科大学附属中医医院;内江市市中区妇幼保健院;内江市第二人民医院;
【基金】：四川省科技厅、泸州市人民政府、泸州医学院合作项目(14JC0173)
【分类号】：R726.1

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