CAJ | 학술논문

目的：观察不同剂量舒芬太尼联合右美托咪定输注对小儿全身麻醉诱导期血流动力学及麻醉趋势指数(NI)的影响。方法下腹部手术患儿45例,随机分为3组：舒芬太尼0.1μg·kg-1+右美托咪定组(S1组)、舒芬太尼0.2μg·kg-1+右美托咪定组(S2组)、舒芬太尼0.3μg·kg-1+右美托咪定组(S3组),每组15例。各组达用药时点后直视气管插管,分别于基础值(t0),右美托咪定0.5μg·kg-1·h-1静脉滴注5 min时(t1)、静脉滴注舒芬太尼3 min时(t2)、插管即刻( t3)、插管后1 min( t4)、5 min( t5)时观察血压、心率、末梢灌注指数( PI)、NI,记录各组阿托品及丙泊酚的应用率,观察苏醒时间及不良反应。结果各组t1、t2时点血流动力学指标和NI 值均显著低于t0时的基础值,PI显著高于t0时的基础值；t3、t4、t5时点S1组上述指标与t0比较差异有统计学意义,且与S2、S3组相比差异有统计学意义；S2、S3组无显著变化；S1组应用丙泊酚6例、手术后躁动4例,较S2、S3组明显增多。 S3组应用阿托品3例。结论0.2μg·kg-1舒芬太尼联合右美托咪定诱导插管用于小儿麻醉,血流动力学稳定,不良反应少。
목적：관찰불동제량서분태니연합우미탁미정수주대소인전신마취유도기혈류동역학급마취추세지수(NI)적영향。방법하복부수술환인45례,수궤분위3조：서분태니0.1μg·kg-1+우미탁미정조(S1조)、서분태니0.2μg·kg-1+우미탁미정조(S2조)、서분태니0.3μg·kg-1+우미탁미정조(S3조),매조15례。각조체용약시점후직시기관삽관,분별우기출치(t0),우미탁미정0.5μg·kg-1·h-1정맥적주5 min시(t1)、정맥적주서분태니3 min시(t2)、삽관즉각( t3)、삽관후1 min( t4)、5 min( t5)시관찰혈압、심솔、말소관주지수( PI)、NI,기록각조아탁품급병박분적응용솔,관찰소성시간급불량반응。결과각조t1、t2시점혈류동역학지표화NI 치균현저저우t0시적기출치,PI현저고우t0시적기출치；t3、t4、t5시점S1조상술지표여t0비교차이유통계학의의,차여S2、S3조상비차이유통계학의의；S2、S3조무현저변화；S1조응용병박분6례、수술후조동4례,교S2、S3조명현증다。 S3조응용아탁품3례。결론0.2μg·kg-1서분태니연합우미탁미정유도삽관용우소인마취,혈류동역학은정,불량반응소。
Objective To investigate the effect of different doses of sufentanil combined with dexmedetomidine ( DEX) on hemodynamic and Narcotrend index ( NI) during pediatric anesthesia induction. Methods A total of 45 children with lower abdominal surgery were randomly divided into three groups evenly: sufentanil 0. 1 μg·kg-1+ DEX (S1 group),sufentanil 0. 2 μg·kg-1+DEX (S2 group),and sufentanil 0. 3μg·kg-1+DEX (S3 group). Patients in each group began with intubation at the peak point of administration. Blood pressure,heart rate,perfusion index (PI) and NI were detected at the baseline (t0), delivering DEX 0.5 μg·kg-1·h-1 and sufentanil intravenously for 5 min (t1),delivering sufentanil for 3 min (t2),time of intubation ( t3 ) ,1 min ( t4 ) ,and 5 min ( t5 ) after intubation. The application rate of atropine and propofol was recorded. Patient recovery time and adverse reactions were observed. Results Compared with basicline value at t0 time point, hemodynamic parameters and NI were decreased at t1 and t2 ,while PI was increased in both groups. At t3 ,t4 ,and t5 ,all of the indicators in S1 group were significantly different from those at t0 ,and also significantly different from those in S2 and S3 group. Six patients were treated with propofol in S1 group and four presented with agitation after operation,more than S2 and S3 groups. Three patients were treatment with atropine in S3 group. Conclusion Sufentanil (0. 2 μg·kg-1 ) combined with dexmedetomidine can be used to induce intubation for pediatric anesthesia with stable hemodynamic profile and low incidence of adverse effects.