CAJ | 학술논문

目的观察右美托咪啶对小儿全麻诱导期不良反应的影响。方法选择40例全麻下行择期外科手术的患儿,美国麻醉医师协会( ASA)分级玉级,随机数字表法分为2组(n=20)：对照组(C组,泵注生理盐水0.15 ml/kg)、右美托咪啶组( D组,泵注右美托咪啶0.6μg/kg)。之后,静脉15 s注射咪达唑仑0.06 mg/kg,2 min后静脉注射丙泊酚2 mg/kg,1 min后静脉注射芬太尼2.5μg/kg。记录丙泊酚注射痛、芬太尼诱发呛咳的发生情况和强度,以及全麻诱导前(T0)、气管插管前(T1)和气管插管后(T2)的平均动脉压(MAP)和心率(HR)。结果C组丙泊酚注射痛发生率为85%,D组无丙泊酚注射痛发生( P<0.01)；两组患儿均无芬太尼诱发呛咳发生；与C组比较,T1时D组MAP升高,T2时D组MAP降低(P<0.01)；与T0时比较,T1时C组MAP降低,T2时C组MAP、HR升高(P<0.01)；与T1时比较,T2时C组MAP、HR均升高( P<0.01)。结论右美托咪啶复合咪达唑仑应用于小儿全麻诱导,无丙泊酚注射痛及芬太尼诱发呛咳发生,且患儿血流动力学稳定。
목적관찰우미탁미정대소인전마유도기불량반응적영향。방법선택40례전마하행택기외과수술적환인,미국마취의사협회( ASA)분급옥급,수궤수자표법분위2조(n=20)：대조조(C조,빙주생리염수0.15 ml/kg)、우미탁미정조( D조,빙주우미탁미정0.6μg/kg)。지후,정맥15 s주사미체서륜0.06 mg/kg,2 min후정맥주사병박분2 mg/kg,1 min후정맥주사분태니2.5μg/kg。기록병박분주사통、분태니유발창해적발생정황화강도,이급전마유도전(T0)、기관삽관전(T1)화기관삽관후(T2)적평균동맥압(MAP)화심솔(HR)。결과C조병박분주사통발생솔위85%,D조무병박분주사통발생( P<0.01)；량조환인균무분태니유발창해발생；여C조비교,T1시D조MAP승고,T2시D조MAP강저(P<0.01)；여T0시비교,T1시C조MAP강저,T2시C조MAP、HR승고(P<0.01)；여T1시비교,T2시C조MAP、HR균승고( P<0.01)。결론우미탁미정복합미체서륜응용우소인전마유도,무병박분주사통급분태니유발창해발생,차환인혈류동역학은정。
Objective To evaluate the efficacy of dexmedetomidine on adverse reaction to anesthesia induction in children. Methods Forty ASA physical status class, undergoing elective surgery pediatric patients were random-ized into two groups of 20 each, using computer-generated random numbers. Group C:normal saline 0.15 ml/kg;Group D:dexmedetomidine 0. 6μg/kg. After aforementioned treatments in each group, midazolam 0.06 mg/kg by injection for 15 s;2 min later, all patients received propofol 2 mg/kg by injection over 20 s, then fentanyl 2.5μg/kg over 5 s. Another anesthesiologist, blind to the pre-treatment, recorded injection pain and fentanyl induced cough;in addition, mean arterial pressure ( MAP) and heart rate ( HR) before anesthesia ( T0 ) , before intubation (T1) and after intubation (T2) were recorded also. Results Seventeen (85%) patients in Group C (control) had pain, and none of patients in Group D had any injection pain (P<0.01). However, there was no fentanyl in-duced cough in all patients. Hemodynamics of Group D were more stable than Group C (P<0.01). ConclusionInjection pain of propofol and fentanyl induced cough can be completely supressed by pretreatment dexmedetomi-dine-midazolam during anesthesia induction in children, and the hemodynamic is stable.