CAJ | 학술논문

目的采用随机双盲的方法观察不同剂量右旋美托咪啶对预防幼儿七氟醚麻醉苏醒期躁动的效果及镇静程度.方法选择择期行唇裂修补术的患儿60例,年龄1～3岁,ASA Ⅰ级,将其随机分为小剂量右旋美托咪啶组(D1)、中等剂量右旋美托咪啶组(D2)及对照组(C),每组20例.各组患儿以单纯七氟醚诱导插管,D1、D2组分别于气管插管后静脉注射右旋美托咪啶0.2μg/kg、0.4μg/kg,注射时间＞10 min,C组静脉注射生理盐水,术中吸入七氟醚维持麻醉深度于Nacrotrend值D水平,术毕待患儿呼吸恢复,保护性发射恢复时拔管.结果三组患者苏醒时间、拔管时间、脉搏氧饱和度(SpO2)均无显著差异(P＞0.05).D1、D2组拔管时和拔管后10 min患儿心率(HR)和平均动脉压(MAP)均比C组明显下降.术后躁动发生率,D1组为26.7％,D2组为6.7％,C组为33.3％,组间比较差异有统计学意义(P＜0.05).D2组患儿清醒镇静程度评分比D1组更高(P＜0.01).三组均未出现严重并发症.结论右旋美托咪可以有效预防幼儿七氟醚麻醉苏醒期躁动.
목적 채용수궤쌍맹적방법관찰불동제량우선미탁미정대예방유인칠불미마취소성기조동적효과급진정정도.방법 선택택기행진렬수보술적환인60례,년령1～3세,ASA Ⅰ급,장기수궤분위소제량우선미탁미정조(D1)、중등제량우선미탁미정조(D2)급대조조(C),매조20례.각조환인이단순칠불미유도삽관,D1、D2조분별우기관삽관후정맥주사우선미탁미정0.2μg/kg、0.4μg/kg,주사시간＞10 min,C조정맥주사생리염수,술중흡입칠불미유지마취심도우Nacrotrend치D수평,술필대환인호흡회복,보호성발사회복시발관.결과 삼조환자소성시간、발관시간、맥박양포화도(SpO2)균무현저차이(P＞0.05).D1、D2조발관시화발관후10 min환인심솔(HR)화평균동맥압(MAP)균비C조명현하강.술후조동발생솔,D1조위26.7％,D2조위6.7％,C조위33.3％,조간비교차이유통계학의의(P＜0.05).D2조환인청성진정정도평분비D1조경고(P＜0.01).삼조균미출현엄중병발증.결론 우선미탁미가이유효예방유인칠불미마취소성기조동.
Objective To explore the effect of preemptive analgesia with different doses of dexmedetomidine on postoperative agitation.Methods Sixty ASA Ⅰ children undergoing cheiloplasty were randomly divided into low-dose dexmedetomidine group (group D1,n =20),moderate-dose dexmedetomidine group (group D2,n =20),and control group (group C,n =20).Anesthesia was induced with sevoflurane for tracheal intubation.In groups D1 and D2,0.2 μ g/kg and 0.4 μ g /kg dexmedetominde were administered intravenously after intubation,and in group C,normal saline was administered.Anesthesia was maintained with uses of sevoflurane.Results There were no significant differences in time to consciousness recovery,extubation time,and pulse oxygen saturation (SpO2) among the three groups (P＞0.05).As compared with group C,heart rate and mean arterial pressure were significantly decreased during extubation and 10 min after extubation in group D1 and D2.The incidence of postoperative agitation was decreased significantly,and sedation extent was increased significantly in group D2 (P＜0.01).Conclusions Dexmedetominde can effectively prevent postoperative agitation during consciousness recovery in children receiving inhalational sevoflurane.