中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2014年
31期
15-16,17
,共3页
右美托咪定%小儿麻醉%术后苏醒
右美託咪定%小兒痳醉%術後囌醒
우미탁미정%소인마취%술후소성
Dexemetomidine%Pediatric anesthesia%Recovery
目的：探讨右美托咪定对小儿扁桃腺摘除术后苏醒的影响。方法：选择ASAⅠ~Ⅱ级、4~12岁、行扁桃腺摘除术的患者30例，随机分为两组。右美托咪定组(Ⅰ组，n=15)在麻醉诱导前静脉恒速微泵注射右美托咪定1μg/kg，10min输注完毕。诱导插管后采用0.7μg/(kg·h)持续静脉微泵注射，手术结束前约半小时停止注射。采用丙泊酚2.5mg/kg，芬太尼0.002~0.003mg/kg，顺阿曲库铵0.1mg/kg诱导，术中以丙泊酚、瑞芬太尼、顺阿曲库铵维持麻醉。对照组(Ⅱ组，n=15)静脉恒速微泵注射等速度和等容量的0.9%氯化钠注射液，麻醉诱导和维持同Ⅰ组。记录两组患者清醒吸痰时(T0)、拔管即刻时(T1)、拔管后5min(T2)、入PACU时(T3)及出PACU时(T4)的平均动脉压(MBP)、心率(HR)。记录拔管时间、入PACU时间、苏醒期疼痛、烦躁、呕吐、嗜睡发生率。结果：T0、T1时Ⅰ组患者MBP、HR均明显低于Ⅱ组患者(P<0.05)；T2时Ⅰ组患者HR明显低于Ⅱ组患者(P<0.05)；其他各时间点Ⅰ组患者与Ⅱ组患者MBP、HR比较差异无统计学意义。Ⅰ组患者较Ⅱ组患者苏醒期疼痛和烦躁的发生率更低(P<0.05)，两组患者的拔管时间、入PACU时间、呕吐发生率、嗜睡发生率比较差异无统计学意义(P>0.05)。结论：小儿患者扁桃体摘除术中联合使用右美托咪定可使苏醒期的血流动力学更加平稳，降低苏醒期疼痛和烦躁的发生。
目的：探討右美託咪定對小兒扁桃腺摘除術後囌醒的影響。方法：選擇ASAⅠ~Ⅱ級、4~12歲、行扁桃腺摘除術的患者30例，隨機分為兩組。右美託咪定組(Ⅰ組，n=15)在痳醉誘導前靜脈恆速微泵註射右美託咪定1μg/kg，10min輸註完畢。誘導插管後採用0.7μg/(kg·h)持續靜脈微泵註射，手術結束前約半小時停止註射。採用丙泊酚2.5mg/kg，芬太尼0.002~0.003mg/kg，順阿麯庫銨0.1mg/kg誘導，術中以丙泊酚、瑞芬太尼、順阿麯庫銨維持痳醉。對照組(Ⅱ組，n=15)靜脈恆速微泵註射等速度和等容量的0.9%氯化鈉註射液，痳醉誘導和維持同Ⅰ組。記錄兩組患者清醒吸痰時(T0)、拔管即刻時(T1)、拔管後5min(T2)、入PACU時(T3)及齣PACU時(T4)的平均動脈壓(MBP)、心率(HR)。記錄拔管時間、入PACU時間、囌醒期疼痛、煩躁、嘔吐、嗜睡髮生率。結果：T0、T1時Ⅰ組患者MBP、HR均明顯低于Ⅱ組患者(P<0.05)；T2時Ⅰ組患者HR明顯低于Ⅱ組患者(P<0.05)；其他各時間點Ⅰ組患者與Ⅱ組患者MBP、HR比較差異無統計學意義。Ⅰ組患者較Ⅱ組患者囌醒期疼痛和煩躁的髮生率更低(P<0.05)，兩組患者的拔管時間、入PACU時間、嘔吐髮生率、嗜睡髮生率比較差異無統計學意義(P>0.05)。結論：小兒患者扁桃體摘除術中聯閤使用右美託咪定可使囌醒期的血流動力學更加平穩，降低囌醒期疼痛和煩躁的髮生。
목적：탐토우미탁미정대소인편도선적제술후소성적영향。방법：선택ASAⅠ~Ⅱ급、4~12세、행편도선적제술적환자30례，수궤분위량조。우미탁미정조(Ⅰ조，n=15)재마취유도전정맥항속미빙주사우미탁미정1μg/kg，10min수주완필。유도삽관후채용0.7μg/(kg·h)지속정맥미빙주사，수술결속전약반소시정지주사。채용병박분2.5mg/kg，분태니0.002~0.003mg/kg，순아곡고안0.1mg/kg유도，술중이병박분、서분태니、순아곡고안유지마취。대조조(Ⅱ조，n=15)정맥항속미빙주사등속도화등용량적0.9%록화납주사액，마취유도화유지동Ⅰ조。기록량조환자청성흡담시(T0)、발관즉각시(T1)、발관후5min(T2)、입PACU시(T3)급출PACU시(T4)적평균동맥압(MBP)、심솔(HR)。기록발관시간、입PACU시간、소성기동통、번조、구토、기수발생솔。결과：T0、T1시Ⅰ조환자MBP、HR균명현저우Ⅱ조환자(P<0.05)；T2시Ⅰ조환자HR명현저우Ⅱ조환자(P<0.05)；기타각시간점Ⅰ조환자여Ⅱ조환자MBP、HR비교차이무통계학의의。Ⅰ조환자교Ⅱ조환자소성기동통화번조적발생솔경저(P<0.05)，량조환자적발관시간、입PACU시간、구토발생솔、기수발생솔비교차이무통계학의의(P>0.05)。결론：소인환자편도체적제술중연합사용우미탁미정가사소성기적혈류동역학경가평은，강저소성기동통화번조적발생。
Objective:To investigate the effect of Dexmedetomidine on recovery process in pediatric anesthesia undergoing tonsil removal surgery. Method:30 patients withⅠtoⅡof ASA physical status,4 to 12 years for radical operations of tonsil removal,were randomly assigned into 2 groups. Patients in the dexmedetomidine group(GroupⅠ,n=15) received an infusion in 10 minutes of Dexmedetomidine 1μg/kg before anesthesia induction and then an infusion of 0.7μg/(kg·h) for maintenance.Patients in the control group(GroupⅡ,n=15) received the same rate and volume of normal saline by infusion.Anesthesia induction was performed using Propofol 2.5 mg/kg,Fentanyl 0.002-0.003 mg/kg,Cis-atracurium 0.1 mg/kg for both GroupⅠand GroupⅡ.Intraoperative Propofol and Remifentanil,Cis-atracurium to maintain anesthesia for both groups.Mean blood pressure(MBP),heart rate(HR), timing of extubation,time of staying in the PACU,adverse effects when awake and suction(T0),extubation time(T1),after extubation 5 min(T2), entering PACU(T3) and out of PACU(T4) were measured and recorded.Result:Comparing with Group Ⅱ,Group Ⅰexperienced less haemodynamic fluctuation(MBP and HR)(P<0.05) at T0 and T1,and lower incidence of pain and restlessness(P<0.05) at T2.There was not statistically significant in MBP and HR between two groups at other time.Comparing with Group Ⅱ,Group Ⅰ experienced lower incidence of pain,restlessness and anxiety(P<0.05). Extubation time,staying in the PACU time,the incidence of vomiting,lethargy incidence difference was no statistically significant between two groups(P>0.05).Conclusion:Dexmedetomidine as an adjunct to general anesthesia for pediatric patients undergoing tonsil removal surgery can keep stable haemodynamics,minimize adverse effects during recovery process.
