中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2013年
7期
895-898
,共4页
右美托咪啶/投药和剂量%投药,鼻内%麻醉恢复期%情绪障碍/预防和控制%儿童
右美託咪啶/投藥和劑量%投藥,鼻內%痳醉恢複期%情緒障礙/預防和控製%兒童
우미탁미정/투약화제량%투약,비내%마취회복기%정서장애/예방화공제%인동
Dexmedetomidine/administration & dosage%Administration,intranasal%Anesthesia recovery period%Mood disorders/prevention & control%Child
目的 观察经鼻滴入右美托咪定对小儿七氟醚麻醉苏醒期躁动的预防作用.方法 选择择期行腺样体或伴有扁桃体切除、年龄2 ～7(3.70 ±1.22)岁、按美国麻醉医师协会(Ammerican Society Anesthsiologists,ASA)分级为Ⅰ级的患儿90例.将90例患儿按随机数字法分为3组(D1,D2,NS),每组30例,七氟醚麻醉诱导前30 min分别经鼻滴入右美托咪定1.0 μg/kg,右美托咪定0.5 μg/kg(容量均配至1ml)及等容量生理盐水,术中以七氟醚、氧气、笑气维持麻醉.术前记录患儿的基础情绪及给药后鼻腔不适感的发生情况,给药即刻至入手术室前每10分钟测一次脉搏、血压及血氧饱和度；术中记录患儿的脉搏、血压、血氧饱和度、手术时间及拔管时间；术后记录苏醒期躁动评分及疼痛评分,同时观察恶心呕吐、嗜睡等不良反应的发生情况.结果 从拔管即刻至术后2hD1组和D2组的躁动评分明显低于NS组,其差异均有统计学意义(P＜0.01).3组患儿给药后至麻醉诱导前,术中以及苏醒期血流动力学、血氧饱和度波动、拔管时间、术后疼痛评分和不良反应比较差异均无统计学意义(P＞0.05).结论 经鼻应用右美托咪定对小儿苏醒期躁动有预防作用.对循环呼吸无影响,不延长拔管时间.
目的 觀察經鼻滴入右美託咪定對小兒七氟醚痳醉囌醒期躁動的預防作用.方法 選擇擇期行腺樣體或伴有扁桃體切除、年齡2 ～7(3.70 ±1.22)歲、按美國痳醉醫師協會(Ammerican Society Anesthsiologists,ASA)分級為Ⅰ級的患兒90例.將90例患兒按隨機數字法分為3組(D1,D2,NS),每組30例,七氟醚痳醉誘導前30 min分彆經鼻滴入右美託咪定1.0 μg/kg,右美託咪定0.5 μg/kg(容量均配至1ml)及等容量生理鹽水,術中以七氟醚、氧氣、笑氣維持痳醉.術前記錄患兒的基礎情緒及給藥後鼻腔不適感的髮生情況,給藥即刻至入手術室前每10分鐘測一次脈搏、血壓及血氧飽和度；術中記錄患兒的脈搏、血壓、血氧飽和度、手術時間及拔管時間；術後記錄囌醒期躁動評分及疼痛評分,同時觀察噁心嘔吐、嗜睡等不良反應的髮生情況.結果 從拔管即刻至術後2hD1組和D2組的躁動評分明顯低于NS組,其差異均有統計學意義(P＜0.01).3組患兒給藥後至痳醉誘導前,術中以及囌醒期血流動力學、血氧飽和度波動、拔管時間、術後疼痛評分和不良反應比較差異均無統計學意義(P＞0.05).結論 經鼻應用右美託咪定對小兒囌醒期躁動有預防作用.對循環呼吸無影響,不延長拔管時間.
목적 관찰경비적입우미탁미정대소인칠불미마취소성기조동적예방작용.방법 선택택기행선양체혹반유편도체절제、년령2 ～7(3.70 ±1.22)세、안미국마취의사협회(Ammerican Society Anesthsiologists,ASA)분급위Ⅰ급적환인90례.장90례환인안수궤수자법분위3조(D1,D2,NS),매조30례,칠불미마취유도전30 min분별경비적입우미탁미정1.0 μg/kg,우미탁미정0.5 μg/kg(용량균배지1ml)급등용량생리염수,술중이칠불미、양기、소기유지마취.술전기록환인적기출정서급급약후비강불괄감적발생정황,급약즉각지입수술실전매10분종측일차맥박、혈압급혈양포화도；술중기록환인적맥박、혈압、혈양포화도、수술시간급발관시간；술후기록소성기조동평분급동통평분,동시관찰악심구토、기수등불량반응적발생정황.결과 종발관즉각지술후2hD1조화D2조적조동평분명현저우NS조,기차이균유통계학의의(P＜0.01).3조환인급약후지마취유도전,술중이급소성기혈류동역학、혈양포화도파동、발관시간、술후동통평분화불량반응비교차이균무통계학의의(P＞0.05).결론 경비응용우미탁미정대소인소성기조동유예방작용.대순배호흡무영향,불연장발관시간.
Objective To investigate whether intranasal dexmedetomidine prevents the emergency delirium after sevoflurane-based anesthesia (ASA) in children.Methods Ninety children (ASA I,2 to 7years) undergoing elective tonsillectomy with or without adenoidectomy,were randomly divided into group D1 (intranasal dexmedemidine 1.0 μg/kg),group D2 (intranasal dexmedemidine 0.5 μg/kg),and group NS (intranasal normal saline).Anesthesia was induced with sevoflurane (30 min after intranasal administration) and maintained with sevoflurane in 50/50％ O2/N2O.Heart rate (HR),blood pressure (BP),and hemoglobin oxygen saturation (SpO2) were monitored before intranasal administration to 2 hours after extubation.Time of operation and extubation were recorded.Pediatric anesthesia emergence delirium (PAED) scale,Modified Children's Hospital of Eastern Ontario Pain Scale (m-CHEOPS) Pain scale and the adverse effects were observed.Results The PAED scales of group D1 and Group D2 were significantly lower than group NS.No significant differences were found in hemodynamic and respiratory variables,pain scale,time of extubation and adverse effects among three groups.Conclusions Intranasal dexmedetomidine decreased the severity of emergence delirium after sevoflurane-based anesthesia in children without prolonging the time to extubate and affect hemodynamics and respiratory variables.
